Healthcare Provider Details

I. General information

NPI: 1386140101
Provider Name (Legal Business Name): BRIAN DAVID WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2018
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 OAK ST STE 3
EUGENE OR
97401-7701
US

IV. Provider business mailing address

1550 OAK ST STE 3
EUGENE OR
97401-7701
US

V. Phone/Fax

Practice location:
  • Phone: 541-683-2020
  • Fax: 541-683-1509
Mailing address:
  • Phone: 541-683-2020
  • Fax: 541-683-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD209075
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: