Individual
BEAU G WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
333 N 1ST ST, SUITE 280, BOISE, ID 83702-6100
(208) 345-6545
(208) 345-1213
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 345-6545
(208) 345-1213
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-788
ID
Other
Enumeration date
01/21/2009
Last updated
09/18/2012
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