Provider Demographics
NPI:1528020179
Name:JEFFREY S. WALKER, MD, PA
Entity Type:Organization
Organization Name:JEFFREY S. WALKER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-528-5941
Mailing Address - Street 1:PO BOX 9623
Mailing Address - Street 2:
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33740-9623
Mailing Address - Country:US
Mailing Address - Phone:727-528-5941
Mailing Address - Fax:727-528-5942
Practice Address - Street 1:6006 49TH ST N
Practice Address - Street 2:#350
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-2148
Practice Address - Country:US
Practice Address - Phone:727-528-5941
Practice Address - Fax:727-528-5942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7058Medicare ID - Type Unspecified