Provider Demographics
NPI:1407485469
Name:WALKER, BROOKS DANIEL (MD)
Entity type:Individual
Prefix:
First Name:BROOKS
Middle Name:DANIEL
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 S DOUGLAS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5269
Mailing Address - Country:US
Mailing Address - Phone:636-227-2600
Mailing Address - Fax:
Practice Address - Street 1:3840 S BOULEVARD STE 101
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5888
Practice Address - Country:US
Practice Address - Phone:405-471-5252
Practice Address - Fax:405-726-8530
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OK43503207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program