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NPI 1417922352

NPI 1417922352 : RONALD R WALCHER MD : TONKAWA, OK

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General NPI Number Information
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    NPI Number           |    1417922352
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    Entity Type          |    Individual 
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    Provider Name        |    RONALD R WALCHER MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/22/2006
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    Last Update Date     |    06/16/2008
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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         |    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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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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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