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Individual

MARK A. WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5131
(740) 446-5486
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5131
(740) 446-5486

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15377
WV
207R00000X
Internal Medicine Physician
Primary
35-04-7305
OH
207RX0202X
Medical Oncology Physician
15377
WV
207RX0202X
Medical Oncology Physician
35-04-7305
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000006739
ANTHEM BCBS
01
000000181881
UNISON MEDICAID #
OH
01
001714036
MOUNTAIN STATE BCBS
05
0083691000
WV
01
0488628
MOLINA MEDICAID #
OH
05
0488628
OH
01
310917085096
CARESOURCE MEDICAID #
OH
01
900000134
RR MEDICARE
OH
Enumeration date
06/26/2006
Last updated
03/05/2011
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