Basic Information
| Provider Information | |||||||||
| NPI: | 1437197621 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | R.PH. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 611 S BITTERSWEET LANE | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66043 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137273141 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4101 SOUTH 4TH STREET TRFWY | ||||||||
| Address2: | |||||||||
| City: | LEAVENWORTH | ||||||||
| State: | KS | ||||||||
| PostalCode: | 66048 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9136822000 | ||||||||
| FaxNumber: | 9137584109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 3541 | ND | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.