Provider Demographics
NPI:1740175306
Name:WALKER, BRODY NICHOLAS (DO)
Entity type:Individual
Prefix:
First Name:BRODY
Middle Name:NICHOLAS
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2654
Mailing Address - Country:US
Mailing Address - Phone:724-415-9979
Mailing Address - Fax:
Practice Address - Street 1:965 SHAMROCK LN
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1196
Practice Address - Country:US
Practice Address - Phone:814-664-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT024773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine