Provider Demographics
NPI:1508283219
Name:WALKER, RICHARD OREN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:OREN
Last Name:WALKER
Suffix:JR
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 1:42340 COUNTY 50 BLVD
Mailing Address - Street 2:
Mailing Address - City:WANAMINGO
Mailing Address - State:MN
Mailing Address - Zip Code:55983-6006
Mailing Address - Country:US
Mailing Address - Phone:507-824-1257
Mailing Address - Fax:
Practice Address - Street 1:42340 COUNTY 50 BLVD
Practice Address - Street 2:
Practice Address - City:WANAMINGO
Practice Address - State:MN
Practice Address - Zip Code:55983-6006
Practice Address - Country:US
Practice Address - Phone:507-824-1257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN290082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry