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Individual

GRANT EDWARD WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3798 JANES RD STE 6, ARCATA, CA 95521-4745
(208) 785-4665
(208) 785-2199
Mailing address
5880 S HOSPITAL DR, GLOBE, AZ 85501-9447
(928) 402-1175
(928) 425-7903

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
11112
MT
207XS0117X
Orthopaedic Surgery of the Spine Physician
30958
AZ
207XS0117X
Orthopaedic Surgery of the Spine Physician
7587A
WY
207XS0117X
Orthopaedic Surgery of the Spine Physician
DR32874
CO
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M8790
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010143629
BLUE SHIELD
ID
01
106308600
DEPT OF LABOR
01
2093784
FIRST HEALTH
01
5470815
CCN
01
54841
BLUE CROSS
ID
01
801254
MEDICARE
CO
05
806635100
ID
Enumeration date
01/30/2007
Last updated
07/21/2020
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