Healthcare Provider Details

I. General information

NPI: 1528000932
Provider Name (Legal Business Name): JOSEPH R WALKER MD CHTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 KIRMAN AVE SUITE 202
RENO NV
89502-1339
US

IV. Provider business mailing address

4840 BUCKHAVEN RD
RENO NV
89509-0961
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number3369
License Number StateNV

VIII. Authorized Official

Name: JOSEPH R WALKER
Title or Position: OWNER
Credential:
Phone: 775-323-2080