Provider Demographics
NPI:1912908450
Name:WALKER, ANDREW FARLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FARLEY
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:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:MONTROSS
Mailing Address - State:VA
Mailing Address - Zip Code:22520-0880
Mailing Address - Country:US
Mailing Address - Phone:804-493-9999
Mailing Address - Fax:804-493-7140
Practice Address - Street 1:18849 KINGS HWY
Practice Address - Street 2:
Practice Address - City:MONTROSS
Practice Address - State:VA
Practice Address - Zip Code:22520-2965
Practice Address - Country:US
Practice Address - Phone:804-493-9999
Practice Address - Fax:804-493-7140
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABW6239239207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA56-3818-6Medicaid
VA288772OtherANTHEM BCBS
VA56-3818-6Medicaid
H14439Medicare UPIN