Individual
DR. KEVIN ROGER WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
215 MOORE RD, KING, NC 27021-8703
(336) 985-2020
(336) 985-2133
Mailing address
PO BOX 207261, DALLAS, TX 75320-7261
(636) 200-4393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1560
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093GR
BCBS PROV #
NC
01
—
268250
ANTHEM BCBS-KING PROV #
NC
01
—
410041919
RAILROAD MEDICARE
NC
05
—
7909939
—
NC
Enumeration date
08/03/2005
Last updated
06/02/2020
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