Provider Demographics
NPI:1770706525
Name:WALKER, RICHARD CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
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 1:2407 N ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3837
Mailing Address - Country:US
Mailing Address - Phone:305-294-1068
Mailing Address - Fax:305-294-4666
Practice Address - Street 1:2407 N ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3837
Practice Address - Country:US
Practice Address - Phone:305-294-1068
Practice Address - Fax:305-294-4666
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0033124207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Not Answered207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD56582Medicare UPIN