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Individual

DR. PHILLIP A WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
16135 NORTH MAY AVE, SUITE A, EDMOND, OK 73013-0000
(405) 751-5638
(405) 752-1692
Mailing address
16135 NORTH MAY AVE, SUITE A, EDMOND, OK 73013-0000
(405) 751-5638
(405) 752-1692

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OK0852
OK
152WC0802X
Corneal and Contact Management Optometrist
852
OK
152WS0006X
Sports Vision Optometrist
852
OK
152WX0102X
Occupational Vision Optometrist
852
OK
156FX1900X
Orthoptist
852
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
730983594001
BLUE CROSS BLUE SHIELD
OK
01
OKAAA3556
PTAN
OK
Enumeration date
01/22/2007
Last updated
03/17/2014
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