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General NPI Number Information
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NPI Number | 1700923018
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Entity Type | Individual
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Provider Name | GRANT EDWARD WALKER MD
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 3798 JANES RD STE 6
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City | ARCATA
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State | CA
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Zip | 95521-4745
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Country | US
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Telephone | 208-785-4665
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Fax | 208-785-2199
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Provider Business Mailing Address
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Address Line | 5880 S HOSPITAL DR
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City | GLOBE
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State | AZ
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Zip | 85501-9447
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Country | US
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Telephone | 928-402-1175
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Fax | 928-425-7903
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 11112
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 7587A
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 30958
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | DR32874
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License Number State | CO
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Taxonomy #5
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | M8790
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License Number State | ID
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