Basic Information
| Provider Information | |||||||||
| NPI: | 1679028690 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | CHAD | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 513 S MUCKEY ST | ||||||||
| Address2: | |||||||||
| City: | MAPLETON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 510341055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7128822234 | ||||||||
| FaxNumber: | 7124239402 | ||||||||
| Practice Location | |||||||||
| Address1: | 513 S MUCKEY ST | ||||||||
| Address2: | |||||||||
| City: | MAPLETON | ||||||||
| State: | IA | ||||||||
| PostalCode: | 51034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7128822234 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2016 | ||||||||
| LastUpdateDate: | 05/17/2018 | ||||||||
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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 | 363A00000X | 083650 | IA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.