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General NPI Number Information
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NPI Number | 1245416510
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Entity Type | Organization
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Legal Business Name | WESLEY J WALKER, O.D. PLLC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 405 S BROADWAY ST
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City | MARLOW
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State | OK
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Zip | 73055-3029
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Country | US
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Telephone | 580-658-6664
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Fax | 580-658-6665
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Provider Business Mailing Address
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Address Line | 405 S BROADWAY ST
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City | MARLOW
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State | OK
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Zip | 73055-3029
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Country | US
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Telephone | 580-658-6664
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Fax | 580-658-6665
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Authorized Official
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Title or Position | INSURANCE/BILLING MANAGER
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Name | MRS. DONNA Y STEWART
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Credential |
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Telephone | 580-658-6664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 1036
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License Number State | OK
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