Individual
BRENT E WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5301 E GRANT RD, ORTHOPAEDIC BLDG, 1ST FLOOR, TUCSON, AZ 85712-2805
(520) 784-6200
(520) 784-6109
Mailing address
PO BOX 31630, ATTN: CREDENTIALING DEPARTMENT, TUCSON, AZ 85751-1630
(520) 784-6200
(520) 784-6109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1400
AZ
363AM0700X
Medical Physician Assistant
1400
AZ
363AS0400X
Surgical Physician Assistant
1400
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175514
—
AZ
Enumeration date
08/03/2005
Last updated
06/14/2013
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