Provider Demographics
NPI:1194994392
Name:KAREN T. WALKER, O. D., PC
Entity type:Organization
Organization Name:KAREN T. WALKER, O. D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:623-594-0325
Mailing Address - Street 1:13470 N 83RD AVE
Mailing Address - Street 2:#300
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4623
Mailing Address - Country:US
Mailing Address - Phone:623-451-8982
Mailing Address - Fax:623-594-0348
Practice Address - Street 1:13470 N 83RD AVE
Practice Address - Street 2:#300
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4623
Practice Address - Country:US
Practice Address - Phone:623-451-8982
Practice Address - Fax:623-594-0348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1589152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty