Provider Demographics
NPI:1346478351
Name:WALKER, MOLLY J (OD)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:J
Last Name:WALKER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-2204
Mailing Address - Country:US
Mailing Address - Phone:641-673-4366
Mailing Address - Fax:641-673-4825
Practice Address - Street 1:303 N 1ST ST
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-2204
Practice Address - Country:US
Practice Address - Phone:641-673-4366
Practice Address - Fax:641-673-4825
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002468152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist