Organization
GRACE LEE WALKER MD PC
Active
Other names
Grace Lee Walker, MD
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE LEE WALKER M.D. (PHYSICIAN)
(812) 232-2683
Entity
Organization
Contact information
Practice address
476 BUCKEYE ST, TERRE HAUTE, IN 47804-4079
(812) 232-2683
Mailing address
476 BUCKEYE ST, TERRE HAUTE, IN 47804-4079
(812) 232-2683
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
01031945
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000250977
ANTHEM
—
05
—
100251460
—
IN
Enumeration date
10/25/2010
Last updated
10/25/2010
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