Individual
TERRY WILLIAM WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
330 N SELTZER ST, CRESTLINE, OH 44827-1403
(419) 462-4556
(419) 462-4557
Mailing address
330 N SELTZER ST, CRESTLINE, OH 44827-1403
(419) 462-4556
(419) 462-4557
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5249
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000241963
ANTHEM
OH
01
—
2201823
UNITED HEALTHCARE
OH
05
—
2263161
—
OH
01
—
410049534
MEDICARE RAILROAD
OH
Enumeration date
07/18/2006
Last updated
08/02/2011
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