Provider Demographics
NPI:1548398126
Name:DOCTORS WALK-IN CARE INC.
Entity Type:Organization
Organization Name:DOCTORS WALK-IN CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:TILYOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-946-8046
Mailing Address - Street 1:222 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4928
Mailing Address - Country:US
Mailing Address - Phone:814-946-8046
Mailing Address - Fax:814-946-3693
Practice Address - Street 1:222 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4928
Practice Address - Country:US
Practice Address - Phone:814-946-8046
Practice Address - Fax:814-946-3693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009212900001Medicaid
PA001598393OtherHIGHMARK BLUE SHIELD
PAB89820Medicare UPIN
PA1009212900001Medicaid