Provider Demographics
NPI:1205017308
Name:WALKER, JONATHAN BAYLESS (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:BAYLESS
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 COUNTY ROAD 605A
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-1227
Mailing Address - Country:US
Mailing Address - Phone:480-735-4032
Mailing Address - Fax:
Practice Address - Street 1:8301 COUNTY ROAD 605A
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-1227
Practice Address - Country:US
Practice Address - Phone:480-735-4032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005260207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine