Provider Demographics
NPI:1245942309
Name:WALKER, TEMIKA M (LDO)
Entity type:Individual
Prefix:MS
First Name:TEMIKA
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12512 LENACRAVE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-4453
Mailing Address - Country:US
Mailing Address - Phone:440-497-9383
Mailing Address - Fax:
Practice Address - Street 1:12512 LENACRAVE AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-4453
Practice Address - Country:US
Practice Address - Phone:440-497-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.007252-S156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician