Provider Demographics
NPI:1851533533
Name:WALKE MEDICAL ASSOCIATION, P.A.
Entity Type:Organization
Organization Name:WALKE MEDICAL ASSOCIATION, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WALKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-673-4672
Mailing Address - Street 1:702 HICKORY ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-5040
Mailing Address - Country:US
Mailing Address - Phone:325-673-4672
Mailing Address - Fax:325-673-2444
Practice Address - Street 1:702 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5040
Practice Address - Country:US
Practice Address - Phone:325-673-4672
Practice Address - Fax:325-673-2444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1166208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty