Provider Demographics
NPI:1801085618
Name:WALKER, SCOTT JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JOHN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2110 SILAS DEANE HWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2313
Mailing Address - Country:US
Mailing Address - Phone:860-258-3470
Mailing Address - Fax:860-571-6800
Practice Address - Street 1:1260 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4362
Practice Address - Country:US
Practice Address - Phone:860-258-3464
Practice Address - Fax:860-571-6812
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2012-02-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT045633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT110010650Medicare PIN