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Individual

CHARLES J. WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3660 GUION RD, INDIANAPOLIS, IN 46222-1697
(317) 920-7139
(317) 920-7229
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
(317) 621-7584
(317) 957-2705

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
02004140A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
35362-021
WI
208D00000X
General Practice Physician
02004140A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201136420
IN
05
30064200
WI
01
P01424274
RAIL ROAD PTAN
IN
Enumeration date
06/10/2005
Last updated
09/27/2015
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