Provider Demographics
NPI:1083660757
Name:WALKER, HEDY G (OD)
Entity Type:Individual
Prefix:
First Name:HEDY
Middle Name:G
Last Name:WALKER
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:11240 HIGHWAY 49
Mailing Address - Street 2:STE 300
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4151
Mailing Address - Country:US
Mailing Address - Phone:228-328-0972
Mailing Address - Fax:228-328-0975
Practice Address - Street 1:11240 HIGHWAY 49
Practice Address - Street 2:STE 300
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4151
Practice Address - Country:US
Practice Address - Phone:228-328-0972
Practice Address - Fax:228-328-0975
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2010-07-01
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Provider Licenses
StateLicense IDTaxonomies
MS646152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSU77364Medicare UPIN