Provider Demographics
NPI:1740279389
Name:WALKER, WALLACE CHESTER (MD)
Entity type:Individual
Prefix:DR
First Name:WALLACE
Middle Name:CHESTER
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:BIG TIMBER
Mailing Address - State:MT
Mailing Address - Zip Code:59011-1267
Mailing Address - Country:US
Mailing Address - Phone:406-932-5419
Mailing Address - Fax:406-932-5515
Practice Address - Street 1:225 BIG TIMBER LOOP RD
Practice Address - Street 2:
Practice Address - City:BIG TIMBER
Practice Address - State:MT
Practice Address - Zip Code:59011-7646
Practice Address - Country:US
Practice Address - Phone:406-932-7100
Practice Address - Fax:406-932-7102
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT6045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine