Provider Demographics
NPI:1467872895
Name:WALKER, CODY (DO)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 REID PARKWAY
Mailing Address - Street 2:MEDICAL STAFF SERVCIES
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374
Mailing Address - Country:US
Mailing Address - Phone:765-935-8802
Mailing Address - Fax:765-983-3219
Practice Address - Street 1:1100 REID PKWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1157
Practice Address - Country:US
Practice Address - Phone:765-935-8747
Practice Address - Fax:765-983-3023
Is Sole Proprietor?:No
Enumeration Date:2014-04-24
Last Update Date:2021-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN02004698A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology