Individual
ALAN GENE WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 584-4861
Mailing address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4306
(719) 584-4861
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
99PA29
NM
363AM0700X
Medical Physician Assistant
99PA29
NM
363AM0700X
Medical Physician Assistant
Primary
PA.0002538
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42731348
—
CO
Enumeration date
09/06/2006
Last updated
06/23/2016
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