Provider Demographics
NPI:1952988560
Name:WALKER, ELIZABETH KAITLIN (DO)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KAITLIN
Last Name:WALKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5432 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2826
Mailing Address - Country:US
Mailing Address - Phone:816-665-1745
Mailing Address - Fax:
Practice Address - Street 1:935 N 1000 W
Practice Address - Street 2:
Practice Address - City:TREMONTON
Practice Address - State:UT
Practice Address - Zip Code:84337-9356
Practice Address - Country:US
Practice Address - Phone:435-207-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0102208706207QS0010X
CODR.0069496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine