Individual
KRIS M WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(208) 238-0009
Mailing address
1951 BENCH RD, SUITE B, POCATELLO, ID 83201-2073
(208) 238-1000
(208) 238-0009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M7081
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010061577
RAILROAD MEDICARE PTAN
ID
05
—
804072000
—
ID
Enumeration date
08/29/2006
Last updated
05/28/2015
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