Provider Demographics
NPI:1164131108
Name:WALKERS UNRIVALED SURGICAL SERVICES
Entity Type:Organization
Organization Name:WALKERS UNRIVALED SURGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANFERNEE
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:470-262-2848
Mailing Address - Street 1:2120 HIGHLAND GATE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-6366
Mailing Address - Country:US
Mailing Address - Phone:470-262-2848
Mailing Address - Fax:
Practice Address - Street 1:2120 HIGHLAND GATE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6366
Practice Address - Country:US
Practice Address - Phone:470-262-2848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Single Specialty