Provider Demographics
NPI:1679612253
Name:WALKER SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:WALKER SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOLFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-588-6588
Mailing Address - Street 1:4020 E BELTLINE AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9324
Mailing Address - Country:US
Mailing Address - Phone:616-588-6570
Mailing Address - Fax:616-647-9119
Practice Address - Street 1:3300 WALKER VIEW DR. NW
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49544
Practice Address - Country:US
Practice Address - Phone:616-588-6570
Practice Address - Fax:616-647-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical