Individual
JERRY D WALKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 N 1900 E, ROOM 4A100 SOM, SALT LAKE CITY, UT 84132
(801) 585-2341
(801) 587-5874
Mailing address
30 N 1900 E, ROOM 4A100 SOM, SALT LAKE CITY, UT 84132
(801) 585-2341
(801) 587-5874
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
52929081205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107017716101
IHC HEALTHPLANS
UT
01
—
25-00402
UNITED HEALTHCARE
UT
01
—
72960
PEHP
UT
01
—
802507
DMBA
UT
05
—
870281028000
—
UT
01
—
870281028WA1
EMIA
UT
01
—
P00100723
PALMETTO GBA
UT
01
—
QM0000067329
ALTIUS
UT
Enumeration date
05/04/2006
Last updated
12/16/2021
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