| Grace Lee Walker, Md | |
|
476 Buckeye St Terre Haute IN 47804-4079 | |
| (812) 232-2683 | |
| Not Available |
| Full Name | Grace Lee Walker, Md |
|---|---|
| Speciality | Clinic/Center |
| Location | 476 Buckeye St, Terre Haute, Indiana |
| Authorized Official Name and Position | Grace Lee Walker (PHYSICIAN) |
| Authorized Official Contact | 8122322683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Lee Walker, Md 476 Buckeye St Terre Haute IN 47804-4079 Ph: (812) 232-2683 | Grace Lee Walker, Md 476 Buckeye St Terre Haute IN 47804-4079 Ph: (812) 232-2683 |
| NPI Number | 1548560543 |
|---|---|
| Provider Enumeration Date | 10/25/2010 |
| Last Update Date | 10/25/2010 |
| Medicare PECOS PAC ID | 5294929386 |
|---|---|
| Medicare Enrollment ID | O20101102001534 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548560543 | NPI | - | NPPES |
| 000000250977 | Other | ANTHEM | |
| 100251460 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 01031945 (Indiana) | Primary |
| Provider Name | Grace Lee Walker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134123607 PECOS PAC ID: 6103010293 Enrollment ID: I20101102001547 |
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