MEDICARE: JENNIFER L WALKER MD

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	207R00000X	Internal Medicine Physician	01076424A	IN
2	207R00000X	Internal Medicine Physician	35663	OK
3	207R00000X	Internal Medicine Physician	2725	VI

General Provider Information

NPI Number	:	1689855934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L WALKER MD

Provider Business Mailing Address
First Line	:	9901 EMMAUS
Second Line	:
City	:	ST JOHN
State	:	VI
Zip	:	00830-9587
Country	:	US
Telephone Number	:	340-642-2652
Fax Number	:

Provider Business Practice Location Address
First Line	:	9901 EMMAUS
Second Line	:
City	:	ST JOHN
State	:	VI
Zip	:	00830-9587
Country	:	US
Telephone Number	:	340-642-2652
Fax Number	:

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

Provider Enumeration Date	:	11/15/2007
Last Update Date	:	09/24/2020

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