Provider Demographics
NPI:1184664229
Name:WALKER, ANDREW B (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:B
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-470-5842
Mailing Address - Fax:251-470-5809
Practice Address - Street 1:1720 CENTER ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-3304
Practice Address - Country:US
Practice Address - Phone:251-415-1475
Practice Address - Fax:251-415-1476
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL235232086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51097754OtherBLUE CROSS
AL51097753OtherBLUE CROSS
MS00122509Medicaid
LA1431257Medicaid
AL17-10541OtherUNITED HEALTH CARE
AL51097754OtherBLUE CROSS