Basic Information
Provider Information
NPI: 1922077411
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALKER
FirstName: LOUIS
MiddleName: EDMOND
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MADIGAN ARMY MEDICAL CENTER
Address2: 9040 REID ST., ATTN: MCHJ-QCR
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Practice Location
Address1: MADIGAN ARMY MEDICAL CENTER
Address2: 9040 REID ST., ATTN: MCHJ-QCR
City: TACOMA
State: WA
PostalCode: 984310001
CountryCode: US
TelephoneNumber: 2539682252
FaxNumber: 2539683278
Other Information
ProviderEnumerationDate: 03/16/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208200000XE1168TXX Allopathic & Osteopathic PhysiciansPlastic Surgery 
2082S0099XE1168TXX Allopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
2082S0105XE1168TXX Allopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand

No ID Information.


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