Provider Demographics
NPI:1649430786
Name:WALKO, JAMES STEPHEN (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:STEPHEN
Last Name:WALKO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 MERCHANT STREET
Mailing Address - Street 2:
Mailing Address - City:AMBRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15003-2465
Mailing Address - Country:US
Mailing Address - Phone:724-266-9047
Mailing Address - Fax:724-251-0651
Practice Address - Street 1:660 MERCHANT ST
Practice Address - Street 2:
Practice Address - City:AMBRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15003-2465
Practice Address - Country:US
Practice Address - Phone:724-266-9047
Practice Address - Fax:724-251-0651
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028990L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice