Provider Demographics
NPI:1366462657
Name:WALKER, SHARON PIKE (PT)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:PIKE
Last Name:WALKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-441-1949
Mailing Address - Fax:740-446-5982
Practice Address - Street 1:20 UNIVERSITY ESTATES BLVD UNIT 120
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701
Practice Address - Country:US
Practice Address - Phone:740-589-7425
Practice Address - Fax:740-589-7429
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
001714166OtherMOUNTAIN STATE BCBS
000000217253OtherANTHEM BCBS
1366462657OtherNPI
OH2530532OtherMOLINA MEDICAID
OH310917085136OtherCARESOURCE MEDICAID
OH310917085136OtherCARESOURCE MEDICAID