Provider Demographics
NPI:1689639510
Name:WALKER, REBECCA P (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:P
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:4420 DIXIE HWY
Practice Address - Street 2:SUITE 128
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2988
Practice Address - Country:US
Practice Address - Phone:502-449-6400
Practice Address - Fax:502-449-6401
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY37292207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2440247000OtherPASSPORT / CMA DBA
KY64054133Medicaid
KYP00216934OtherRAILROAD MEDICARE
017233OtherSIHO / CMA DBA
IN200393600Medicaid
9432089003OtherCIGNA / CMA DBA
000000350752OtherANTHEM / CMA DBA
00005215COtherHUMANA / CMA DBA
1168002OtherPASSPORT / CMA DBA
IN200393600Medicaid
00005215COtherHUMANA / CMA DBA
000000350752OtherANTHEM / CMA DBA