Provider Demographics
NPI:1417399809
Name:WALKER, MELANIE G
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:G
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 N. BICKFORD
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-9999
Mailing Address - Country:US
Mailing Address - Phone:405-262-7227
Mailing Address - Fax:405-265-7577
Practice Address - Street 1:108 N. BICKFORD
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-9999
Practice Address - Country:US
Practice Address - Phone:405-262-7227
Practice Address - Fax:405-265-7577
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist