Provider Demographics
NPI:1396799078
Name:WALKER, DANIEL E (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 W TOWNLINE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CRESTON
Mailing Address - State:IA
Mailing Address - Zip Code:50801-1066
Mailing Address - Country:US
Mailing Address - Phone:641-782-2131
Mailing Address - Fax:641-782-6425
Practice Address - Street 1:1610 W TOWNLINE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CRESTON
Practice Address - State:IA
Practice Address - Zip Code:50801-1066
Practice Address - Country:US
Practice Address - Phone:641-782-2131
Practice Address - Fax:641-782-6425
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA02272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1396799078Medicaid
IA080058726OtherRAILROAD MEDICARE NONBILL
13594Medicare ID - Type UnspecifiedMEDICARE NON BILLING NUMB
F64295Medicare UPIN