Provider Demographics
NPI:1104018829
Name:A D WALKER JR MD APMC
Entity Type:Organization
Organization Name:A D WALKER JR MD APMC
Other - Org Name:BAYOU ORTHOPEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:DELMAR
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:985-868-7566
Mailing Address - Street 1:869 VERRET ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4635
Mailing Address - Country:US
Mailing Address - Phone:985-868-7566
Mailing Address - Fax:985-851-4778
Practice Address - Street 1:869 VERRET ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4635
Practice Address - Country:US
Practice Address - Phone:985-868-7566
Practice Address - Fax:985-851-4778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA013854174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1319392Medicaid
LA57349Medicare PIN
LAB60610Medicare UPIN
LA200016290Medicare PIN