Provider Demographics
NPI:1396706123
Name:WALKER, NEAL S (DO)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:S
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 REDTAIL RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1841
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:410 W LINFIELD TRAPPE RD
Practice Address - Street 2:240
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4295
Practice Address - Country:US
Practice Address - Phone:610-495-6500
Practice Address - Fax:610-495-6558
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010136L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1308710OtherHIGHMARK BLUE SHIELD
PA50012511OtherCAPITOL BLUE CROSS
PA2601155OtherAETNA
PAP00109725OtherRAILROAD MEDICARE
PA2002823000OtherINDEPENDENCE BLUE CROSS
PA50012511OtherCAPITOL BLUE CROSS
PA2601155OtherAETNA