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General NPI Number Information
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NPI Number | 1548330053
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Entity Type | Organization
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Legal Business Name | PHILLIP A. WALKER O.D. INC.
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 16135 NORTH MAY AVENUE SUITE A
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-751-5638
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Fax | 405-752-1692
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Provider Business Mailing Address
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Address Line | 16135 NORTH MAY AVENUE SUITE A
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City | EDMOND
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-751-5638
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Fax | 405-752-1692
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP A. WALKER
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Credential | O.D.
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Telephone | 405-751-5638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 852
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 852
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 852
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 152WX0102X
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Taxonomy Name | Occupational Vision Optometrist
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License Number | 852
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number | 852
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 156FC0801X
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Taxonomy Name | Contact Lens Fitter
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License Number | 852
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 852
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License Number State | OK
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Taxonomy #8
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 852
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License Number State | OK
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Taxonomy #9
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 852
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License Number State | OK
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