Provider Demographics
NPI:1861443889
Name:WALKER, BAIRN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:BAIRN
Middle Name:MICHAEL
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 1:36 N GOULD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-6497
Mailing Address - Country:US
Mailing Address - Phone:307-429-0430
Mailing Address - Fax:
Practice Address - Street 1:36 N GOULD ST STE 201
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-6497
Practice Address - Country:US
Practice Address - Phone:307-429-0430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD64248207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I55502Medicare UPIN
0097Medicare ID - Type UnspecifiedMEDICAIRE IPIN