Individual
DR. JERRY H WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
390 SOUTH 3RD WEST, SODA SPRINGS, ID 83276
(208) 547-2220
(208) 547-2224
Mailing address
390 SOUTH 3RD WEST, SODA SPRINGS, ID 83276
(208) 547-2220
(208) 547-2224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-3839
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807893200
—
ID
Enumeration date
10/20/2005
Last updated
05/26/2009
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