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Individual

DR. GRACE LEE WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
476 BUCKEYE ST, TERRE HAUTE, IN 47804-4079
(812) 232-2683
(812) 877-4620
Mailing address
476 BUCKEYE ST, TERRE HAUTE, IN 47804-4079
(812) 232-2683
(812) 877-4620

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031945
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01031945
PHYSICIAN LICENSE
IN
05
100251460
IN
01
1134123607
NPI
IN
Enumeration date
06/11/2005
Last updated
01/22/2015
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