Individual
MR. DERRICK W WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 E WASHINGTON ST, SUITE 200, INDIANAPOLIS, IN 46219-2890
(317) 355-7171
(317) 355-9022
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 355-7199
(317) 355-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01068282A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11015165A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201060400
—
IN
01
—
P01157069
RR MEDICARE PTAN
IN
Enumeration date
07/14/2009
Last updated
02/06/2017
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