Provider Demographics
NPI:1093373904
Name:WALKER, BENJAMIN (PA-C)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 ROLLING RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3339
Mailing Address - Country:US
Mailing Address - Phone:615-815-0167
Mailing Address - Fax:
Practice Address - Street 1:6312 HIGHWAY 41A STE 108
Practice Address - Street 2:
Practice Address - City:PLEASANT VIEW
Practice Address - State:TN
Practice Address - Zip Code:37146-8221
Practice Address - Country:US
Practice Address - Phone:615-815-0167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3851363A00000X
KYPA2958363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant