Provider Demographics
NPI:1205038098
Name:WALKER, PAUL LEXINGTON (DPM)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:LEXINGTON
Last Name:WALKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 NW 46TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2039
Mailing Address - Country:US
Mailing Address - Phone:754-246-5354
Mailing Address - Fax:954-563-3499
Practice Address - Street 1:512 W OAKLAND PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1726
Practice Address - Country:US
Practice Address - Phone:954-563-3499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 2587213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU63868Medicare UPIN
FL65471Medicare ID - Type Unspecified