Provider Demographics
NPI:1154415719
Name:WALKER, ERIC
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-3055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 TRINITY POINT DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2974
Practice Address - Country:US
Practice Address - Phone:724-229-7769
Practice Address - Fax:724-229-7792
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25108OtherSPECTERA
PA343102OtherBLUE CROSS/ BLUE SHIELD
PA49997OtherDAVIS VISION