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Individual

DR. SEAN THOMAS WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(303) 761-9190
(720) 874-4462
Mailing address
10800 E GEDDES AVE STE 300, ENGLEWOOD, CO 80112-3895
(303) 761-9190
(720) 874-4462

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-39693
KS
2085R0202X
Diagnostic Radiology Physician
27792
NE
2085R0202X
Diagnostic Radiology Physician
57947
CO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
27792
NE
2085R0204X
Vascular & Interventional Radiology Physician
57947
CO
390200000X
Student in an Organized Health Care Education/Training Program
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111257098
MEDICARE PIN
KS
05
1568758878
CO
01
561591YQ33
MEDICARE PIN
CO
01
561591YQ3L
MEDICARE PIN
CO
01
561591YQN9
MEDICARE PIN
CO
01
561591YQPG
MEDICARE PIN
CO
01
561591ZLJ3
MEDICARE PIN
CO
01
KA3249089
MEDICARE PIN
KS
01
NA1214114
MEDICARE PIN
NE
01
NA1215112
MEDICARE PIN
NE
01
NA2517093
MEDICARE PIN
NE
Enumeration date
06/24/2011
Last updated
03/31/2024
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