Provider Demographics
NPI:1366524928
Name:WALKER, EARL D (DMD)
Entity type:Individual
Prefix:DR
First Name:EARL
Middle Name:D
Last Name:WALKER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3036 BRECKENRIDGE LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-2196
Mailing Address - Country:US
Mailing Address - Phone:502-495-1822
Mailing Address - Fax:502-495-1825
Practice Address - Street 1:3036 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-2196
Practice Address - Country:US
Practice Address - Phone:502-495-1822
Practice Address - Fax:502-495-1825
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY61021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics