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General NPI Number Information
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NPI Number | 1467571216
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Entity Type | Individual
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Provider Name | MARTHA Y WALKUP DO
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 1578 N GREENHILL RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-2454
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Country | US
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Telephone | 615-509-3366
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Fax | 615-773-4502
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Provider Business Mailing Address
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Address Line | 1578 N GREENHILL RD
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City | MOUNT JULIET
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State | TN
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Zip | 37122-2454
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Country | US
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Telephone | 615-509-3366
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Fax | 615-773-4502
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | DO 0573
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | H2087 DO
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License Number State | TX
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