Organization
GARY P WALKER OD PC
Active
Other names
Eastland Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED P WALKER O.D. (PRESIDENT)
(208) 733-1944
Entity
Organization
Contact information
Practice address
1067 EASTLAND DR, TWIN FALLS, ID 83301-6747
(208) 733-1944
(208) 734-4984
Mailing address
1067 EASTLAND DR, TWIN FALLS, ID 83301-6747
(208) 733-1944
(208) 734-4984
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-0539
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477657013
—
ID
05
—
806642800
—
ID
Enumeration date
09/12/2006
Last updated
03/17/2023
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