Provider Demographics
NPI:1851730246
Name:ERIC S. WALKER O.D. AND ASSOCIATES
Entity Type:Organization
Organization Name:ERIC S. WALKER O.D. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:O.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-229-7769
Mailing Address - Street 1:1026 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-3055
Mailing Address - Country:US
Mailing Address - Phone:724-229-7769
Mailing Address - Fax:724-229-7792
Practice Address - Street 1:30 TRINITY POINT DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2974
Practice Address - Country:US
Practice Address - Phone:724-229-7769
Practice Address - Fax:724-229-7792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028281320001Medicaid