Provider Demographics
NPI:1871574335
Name:WALKER, ROBERT STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEPHEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:DEPT 86236
Mailing Address - Street 2:PO BOX 950195
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0001
Mailing Address - Country:US
Mailing Address - Phone:502-636-7449
Mailing Address - Fax:502-933-8323
Practice Address - Street 1:1 AUDUBON PLAZA DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1318
Practice Address - Country:US
Practice Address - Phone:502-363-7449
Practice Address - Fax:502-933-8323
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY15556207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64155567Medicaid
KY64155567Medicaid
KYC73374Medicare UPIN
KY0783041Medicare PIN