Provider Demographics
NPI:1770849358
Name:WALKER, SCOTT EUGENE (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EUGENE
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:863 LANCASTER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99712-1119
Mailing Address - Country:US
Mailing Address - Phone:907-455-8040
Mailing Address - Fax:
Practice Address - Street 1:3755 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4610
Practice Address - Country:US
Practice Address - Phone:907-474-1433
Practice Address - Fax:907-474-1447
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist