Provider Demographics
NPI:1700831237
Name:WALKER ORTHOTICS AND PROSTHETICS INC
Entity Type:Organization
Organization Name:WALKER ORTHOTICS AND PROSTHETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:ESPY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-232-4383
Mailing Address - Street 1:205 REDMOND ROAD
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165
Mailing Address - Country:US
Mailing Address - Phone:706-232-4383
Mailing Address - Fax:706-232-4667
Practice Address - Street 1:205 REDMOND ROAD
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165
Practice Address - Country:US
Practice Address - Phone:706-232-4383
Practice Address - Fax:706-232-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00971506AMedicaid
GA4587180001Medicare ID - Type Unspecified