Provider Demographics
NPI:1851495303
Name:WALKER, DAVID S (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4265
Mailing Address - Country:US
Mailing Address - Phone:740-355-3989
Mailing Address - Fax:740-355-0419
Practice Address - Street 1:723 8TH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4265
Practice Address - Country:US
Practice Address - Phone:740-355-3989
Practice Address - Fax:740-355-0419
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276366Medicaid
KY64953334Medicaid
OH0276366Medicaid
OH0816224Medicare PIN