Provider Demographics
NPI:1255309910
Name:WALKER, ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 12TH STREET EXT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2352
Mailing Address - Country:US
Mailing Address - Phone:304-487-8271
Mailing Address - Fax:304-487-5666
Practice Address - Street 1:120 12TH STREET EXT
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2352
Practice Address - Country:US
Practice Address - Phone:304-487-8271
Practice Address - Fax:304-487-5666
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24684208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA91962OtherSENTARA
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherCORVEL/CORCARE
VA010128633Medicaid
VA2129399OtherUHC/MAMSI
VAPAROtherCIGNA
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VA173758OtherANTHEM
VA-017OtherTRICARE/CHAMPUS
VA10002753OtherSENTARA/OPTIMA
NC89067RKMedicaid
VAPAROtherVIRGINIA HEALTH NETWORK
NC067RKOtherBC/BS
VAPAROtherAETNA
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA250013765Medicare PIN
VA173758OtherANTHEM
VAPAROtherCIGNA
VAPAROtherVIRGINIA HEALTH NETWORK