Provider Demographics
NPI:1144205568
Name:WALKER, JAMES WHITTENBURG JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WHITTENBURG
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1708
Mailing Address - Country:US
Mailing Address - Phone:806-414-9100
Mailing Address - Fax:806-354-5717
Practice Address - Street 1:1400 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1786
Practice Address - Country:US
Practice Address - Phone:806-414-9100
Practice Address - Fax:806-354-5717
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200347260 AMedicaid
TXP089K7726Medicaid
TX132290108Medicaid
TX132290109Medicaid
NM64971589Medicaid
NM64971589Medicaid
E90751Medicare UPIN
TXTXB136072Medicare PIN