Provider Demographics
NPI:1780013920
Name:WALKER, ROGER ASHLEY (DO)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:ASHLEY
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 LAKE WORTH RD STE 302
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2906
Mailing Address - Country:US
Mailing Address - Phone:561-570-2501
Mailing Address - Fax:
Practice Address - Street 1:6415 LAKE WORTH RD STE 101
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3009
Practice Address - Country:US
Practice Address - Phone:561-570-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15316207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery