Healthcare Provider Details

I. General information

NPI: 1649200213
Provider Name (Legal Business Name): JOE R WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

614 CONCORD SQUARE DR
LAWRENCEBURG IN
47025-7858
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-6304
  • Fax:
Mailing address:
  • Phone: 812-539-2313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD 7111
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: