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General NPI Number Information
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NPI Number | 1124150214
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Entity Type | Organization
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Legal Business Name | RONALD R WALCHER MD INC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 600 E GRAND AVE
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City | TONKAWA
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State | OK
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Zip | 74653-3545
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Country | US
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Telephone | 580-628-2557
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Fax | 580-628-2132
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Provider Business Mailing Address
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Address Line | PO BOX 8
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City | TONKAWA
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State | OK
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Zip | 74653-0008
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Country | US
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Telephone | 580-628-2557
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Fax | 580-628-2132
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Authorized Official
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Title or Position | PRFESIDENT
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Name | DR. RONALD R WALCHER
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Credential | M.D.
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Telephone | 580-628-2557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12238
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License Number State | OK
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