MEDICARE: JON W 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	207Q00000X	Family Medicine Physician	H2885	TX

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
2	PENDING	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1548428766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JON W WALKER, M.D.

Provider Business Mailing Address
First Line	:	800 MEDICAL CENTER DR
Second Line	:	SUITE C-1
City	:	DECATUR
State	:	TX
Zip	:	76234-3843
Country	:	US
Telephone Number	:	940-626-3886
Fax Number	:	940-626-3887

Provider Business Practice Location Address
First Line	:	800 MEDICAL CENTER DR
Second Line	:	SUITE C-1
City	:	DECATUR
State	:	TX
Zip	:	76234-3843
Country	:	US
Telephone Number	:	940-626-3886
Fax Number	:	940-626-3887

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. JON W WALKER
Credential	:	M.D.
Telephone Number	:	940-626-3886

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	01/07/2009

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