Basic Information
| Provider Information | |||||||||
| NPI: | 1386616910 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1460 | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224021460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407862100 | ||||||||
| FaxNumber: | 5407866673 | ||||||||
| Practice Location | |||||||||
| Address1: | 1451 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224018424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408995864 | ||||||||
| FaxNumber: | 5403722023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 02/08/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 0101237076 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0101237076 | 01 | VA | LICENSE | OTHER | 3633117 | 01 | VA | AETNA HMO | OTHER | 2127915 | 01 | VA | MAMSI | OTHER | 010170362 | 05 | VA | MEDICAID | 7803098 | 01 | VA | AETNA NON HMO | OTHER | CA9037 | 01 | VA | MCR RAILROAD GROUP | OTHER | P00274787 | 01 | VA | MEDICARE RAILROAD | OTHER | 146716 | 01 | VA | ANTHEM | OTHER | C02375 | 01 | VA | MEDICARE GROUP | OTHER |