Provider Demographics
NPI:1891878500
Name:WALKER, BRIAN PATRICK (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:PATRICK
Last Name:WALKER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4004 DUPONT CIRCLE
Mailing Address - Street 2:STE 220
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4819
Mailing Address - Country:US
Mailing Address - Phone:502-893-0159
Mailing Address - Fax:502-893-9734
Practice Address - Street 1:4004 DUPONT CIRCLE
Practice Address - Street 2:STE 220
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4819
Practice Address - Country:US
Practice Address - Phone:502-893-0159
Practice Address - Fax:502-893-9734
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA949207Y00000X
IN10000857A207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology