Walker, Jerry H
Walker, Jerry H is an individual health care provider with primary practice located at 390 South 3Rd West , Soda Springs ID 83276. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Walker, Jerry H can be contacted via phone (208) 547-2220.Contact Information
Primary practice address
390 South 3Rd West
Soda Springs ID 83276
Phone: (208) 547-2220
Fax: (208) 547-2224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D-3839 | Idaho |
Profile Details
| NPI number | 1154310373 |
|---|---|
| LBN Legal business name | Walker, Jerry H |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | May 26th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154310373 | NPPES |
| Idaho | MEDICAID | 807893200 |
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