Provider Demographics
NPI:1871642090
Name:WALKER, REBECCA ALLISON (MD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ALLISON
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9314 PARKWEST BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4303
Mailing Address - Country:US
Mailing Address - Phone:865-690-7677
Mailing Address - Fax:865-690-7627
Practice Address - Street 1:9314 PARKWEST BLVD.
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4303
Practice Address - Country:US
Practice Address - Phone:865-690-7677
Practice Address - Fax:865-690-7627
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000029405174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNG55734Medicare UPIN
TN3812652Medicare PIN