Individual
DR. DOUGLAS JOHN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
937 CHETCO AVE STE K 4005, BROOKINGS, OR 97415
(541) 469-6923
(541) 469-6769
Mailing address
937 CHETCO AVE STE K4005, BROOKINGS, OR 97415-0228
(541) 469-6923
(541) 469-6769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR 2740-AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2083170
—
OR
01
—
R113489
MEDICARE GROUP PIN
OR
Enumeration date
07/28/2005
Last updated
06/02/2022
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