Provider Demographics
NPI:1689889792
Name:WALKER, COURTNYE A (MD)
Entity Type:Individual
Prefix:
First Name:COURTNYE
Middle Name:A
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8300 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-1844
Mailing Address - Country:US
Mailing Address - Phone:843-324-8551
Mailing Address - Fax:
Practice Address - Street 1:10777 NALL AVE STE 315
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1346
Practice Address - Country:US
Practice Address - Phone:913-276-4481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-45545208G00000X
NC138793208G00000X
ARE-6383208G00000X
MO2011038218208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1689889792Medicaid
OK200295620AMedicaid
OK200295620AMedicaid
AR5AD11Medicare PIN