Provider Demographics
NPI:1689872046
Name:JARET WALKER, DPM PA
Entity Type:Organization
Organization Name:JARET WALKER, DPM PA
Other - Org Name:ADVANCED FOOT AND ANKLE SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARET
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:940-382-8400
Mailing Address - Street 1:3205 MEDPARK
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-6932
Mailing Address - Country:US
Mailing Address - Phone:940-382-8400
Mailing Address - Fax:940-382-8422
Practice Address - Street 1:3205 MEDPARK
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-6932
Practice Address - Country:US
Practice Address - Phone:940-382-8400
Practice Address - Fax:940-382-8422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00012ZMedicare PIN
TX5414410001Medicare NSC