Provider Demographics
NPI:1538157888
Name:OAKS, WALTER ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:ALLEN
Last Name:OAKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0687
Mailing Address - Country:US
Mailing Address - Phone:251-316-3868
Mailing Address - Fax:251-316-3583
Practice Address - Street 1:100 MEMORIAL HOSPITAL DR
Practice Address - Street 2:STE 1E
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1183
Practice Address - Country:US
Practice Address - Phone:251-316-3868
Practice Address - Fax:251-316-3583
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051538738OtherBCBS - PAM
AL051529560OtherBLUE CROSS BLUE SHIELD
ALP00387111OtherRAILROAD MEDICARE - RTO
AL009942022Medicaid
AL051538834OtherBCBS - RTO
ALP00231791OtherRAILROAD MEDICARE
ALP00450207OtherRR MEDICARE - PET CT
AL009940617Medicaid
AL051538361OtherBCBS - PET
ALP00371847OtherRAILROAD MEDICARE - PAM
AL009933706Medicaid
AL009940632Medicaid
C76229Medicare UPIN
AL051558506Medicare PIN
ALP00371847OtherRAILROAD MEDICARE - PAM
AL009940632Medicaid
AL009933706Medicaid