Provider Demographics
NPI:1356748099
Name:WALKER, JON GILCHRIST (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:GILCHRIST
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 1:110 N DUKE ST
Mailing Address - Street 2:APT 301
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2804
Mailing Address - Country:US
Mailing Address - Phone:717-393-3555
Mailing Address - Fax:
Practice Address - Street 1:110 N DUKE ST
Practice Address - Street 2:APT 301
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2804
Practice Address - Country:US
Practice Address - Phone:717-393-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017170E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology