MEDICARE: DR. TIMOTHY FRANK WALKER DDS

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	1223G0001X	General Practice Dentistry	5360	NE

General Provider Information

NPI Number	:	1568440006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY FRANK WALKER DDS

Provider Business Mailing Address
First Line	:	10103 S 179TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-1967
Country	:	US
Telephone Number	:	402-981-3848
Fax Number	:

Provider Business Practice Location Address
First Line	:	10103 S 179TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68136-1967
Country	:	US
Telephone Number	:	402-981-3848
Fax Number	:

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	04/07/2009

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