Provider Demographics
NPI:1396980546
Name:WALKER & WALKER P.L.L.C.
Entity type:Organization
Organization Name:WALKER & WALKER P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-478-8400
Mailing Address - Street 1:106 LONE OAK CR
Mailing Address - Street 2:
Mailing Address - City:FT. GIBSON
Mailing Address - State:OK
Mailing Address - Zip Code:74434
Mailing Address - Country:US
Mailing Address - Phone:918-478-8400
Mailing Address - Fax:
Practice Address - Street 1:106 LONE OAK CR
Practice Address - Street 2:
Practice Address - City:FT. GIBSON
Practice Address - State:OK
Practice Address - Zip Code:74434
Practice Address - Country:US
Practice Address - Phone:918-478-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5989122300000X
OK5799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty