Provider Demographics
NPI:1073834503
Name:HOWARD S WALKER, MD
Entity Type:Organization
Organization Name:HOWARD S WALKER, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:S J
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:251-340-7950
Mailing Address - Street 1:P. O. BOX 9391
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-0391
Mailing Address - Country:US
Mailing Address - Phone:251-460-0326
Mailing Address - Fax:251-460-2846
Practice Address - Street 1:3715 DAUPHIN ST
Practice Address - Street 2:SUITE 6 C
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1771
Practice Address - Country:US
Practice Address - Phone:251-460-0326
Practice Address - Fax:251-460-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051554184Medicaid
AL051554184Medicaid