Provider Demographics
NPI:1093866493
Name:WALKER, CARL KILPATRICK (DMD,MS)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:KILPATRICK
Last Name:WALKER
Suffix:
Gender:M
Credentials:DMD,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 CONROY RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-4424
Mailing Address - Country:US
Mailing Address - Phone:205-595-5537
Mailing Address - Fax:
Practice Address - Street 1:521 MONTGOMERY HWY
Practice Address - Street 2:SUITE 125
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-1878
Practice Address - Country:US
Practice Address - Phone:205-823-1583
Practice Address - Fax:205-823-1590
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41321223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL47-0863717OtherTAX IDENTIFICATION NUMBER