Provider Demographics
NPI:1982885950
Name:PAUL F. WALKER MD,PC
Entity Type:Organization
Organization Name:PAUL F. WALKER MD,PC
Other - Org Name:ALLERGY & ASTHMA CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:413-732-1699
Mailing Address - Street 1:3455 MAIN ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1147
Mailing Address - Country:US
Mailing Address - Phone:413-732-1699
Mailing Address - Fax:413-781-2319
Practice Address - Street 1:3455 MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1147
Practice Address - Country:US
Practice Address - Phone:413-732-1699
Practice Address - Fax:413-781-2319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38403207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
M16055OtherMEDICARE GROUP NUMBER