Individual
DR. GORDON R. WALKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
804 MOOREFIELD PARK DR, SUITE 201, NORTH CHESTERFIELD, VA 23236-3670
(804) 560-4640
(804) 560-4813
Mailing address
804 MOOREFIELD PARK DR, SUITE 201, NORTH CHESTERFIELD, VA 23236-3670
(804) 560-4640
(804) 560-4813
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002339
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007730624
—
VA
01
—
085796
SENTARA
VA
01
—
090944
ANTHEM F&A
VA
01
—
090961
ANTHEM
VA
01
—
P00159187
RAILROAD MEDICARE
VA
Enumeration date
10/25/2006
Last updated
05/21/2015
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