Organization
EYE CENTER OF BROOKINGS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS JOHN WALKER OD (MEMBER)
(541) 469-6923
Entity
Organization
Contact information
Practice address
937 CHETCO AVE, BROOKINGS, OR 97415
(541) 469-6923
(541) 469-6769
Mailing address
PO BOX 4005, BROOKINGS, OR 97415-0228
(541) 469-6923
(541) 469-6769
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OR 2740 ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208317
—
OR
Enumeration date
08/16/2006
Last updated
06/02/2022
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