Healthcare Provider Details
I. General information
NPI: 1447456843
Provider Name (Legal Business Name): HUGH D WALKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/22/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3321 W 11TH AVE
EUGENE OR
97402-3040
US
IV. Provider business mailing address
3321 W 11TH AVE
EUGENE OR
97402-3040
US
V. Phone/Fax
- Phone: 541-685-1800
- Fax: 541-685-1919
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MD06015 |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | MD06015 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: