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NPI Code Detail

MEDICARE: BRADFORD P WALKER OD

MEDICARE:   BRADFORD P WALKER  OD
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
1152W00000XOptometrist2526-035WI

Other Identifiers

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

General Provider Information

NPI Number : 1598718348
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADFORD P WALKER OD
Provider Business Mailing Address
First Line : 165 W HASELTINE ST
Second Line :
City : RICHLAND CENTER
State : WI
Zip : 53581-2552
Country : US
Telephone Number : 608-647-8995
Fax Number : 608-647-2569
Provider Business Practice Location Address
First Line : 165 W HASELTINE ST
Second Line :
City : RICHLAND CENTER
State : WI
Zip : 53581-2552
Country : US
Telephone Number : 608-647-8995
Fax Number : 608-647-2569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 01/14/2016

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Directions to “ BRADFORD P WALKER OD” Practice Location

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