Provider Demographics
NPI:1376823443
Name:WALKER, FREDERICK ALLEN (DO)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ALLEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23509
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-0509
Mailing Address - Country:US
Mailing Address - Phone:502-384-2343
Mailing Address - Fax:502-365-2937
Practice Address - Street 1:11405 PARK RD STE 160
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2427
Practice Address - Country:US
Practice Address - Phone:502-384-2343
Practice Address - Fax:502-365-2937
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY029072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry