Provider Demographics
NPI:1932542701
Name:WALKER, KYLE EDWARD (MD)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:EDWARD
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6620 COYLE AVE
Mailing Address - Street 2:#212
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2307
Mailing Address - Country:US
Mailing Address - Phone:916-536-9455
Mailing Address - Fax:916-536-9424
Practice Address - Street 1:6620 COYLE AVE
Practice Address - Street 2:#212
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-536-9455
Practice Address - Fax:916-536-9424
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA1873842086X0206X, 207X00000X
NY288924208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice