MEDICARE: DR. BRADLEY S WALKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	G73117	CA
2	208D00000X	General Practice Physician	7042	NV
3	2083X0100X	Occupational Medicine Physician	G73117	CA
4	2083P0901X	Public Health & General Preventive Medicine Physician	G73117	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194783530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY S WALKER M.D.

Provider Business Mailing Address
First Line	:	383 N 1340 E
Second Line	:
City	:	PROVO
State	:	UT
Zip	:	84606-5169
Country	:	US
Telephone Number	:	702-528-4297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1735 N NELLIS BLVD STE G
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-3671
Country	:	US
Telephone Number	:	702-342-8804
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	01/30/2026

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