MEDICARE: ROBERT SCOTT WALKER P.T.

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	225100000X	Physical Therapist	5385	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	753120978	OTHER	AZ	TRICARE
2	753120978	OTHER	AZ	AETNA
3	AZ0463540	OTHER	AZ	BCBS
4	753120978	OTHER	AZ	BANNER LPHO
5	753120978	OTHER	AZ	HUMANA
6	2Z223	OTHER	AZ	HEALTHNET HMO PPO

General Provider Information

NPI Number	:	1285685206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SCOTT WALKER P.T.

Provider Business Mailing Address
First Line	:	303 N CENTENNIAL WAY
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-6733
Country	:	US
Telephone Number	:	480-649-3111
Fax Number	:	480-649-3113

Provider Business Practice Location Address
First Line	:	303 N CENTENNIAL WAY
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85201-6733
Country	:	US
Telephone Number	:	480-649-3111
Fax Number	:	480-649-3113

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	09/30/2011

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Directions to “ ROBERT SCOTT WALKER P.T.” Practice Location

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