Provider Demographics
NPI:1184668246
Name:WALKER, WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:WALKER
Suffix:
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:MERIT HEALTH MEDICAL GROUP-SUMRALL
Mailing Address - Street 2:4891 HWY 589
Mailing Address - City:SUMRALL
Mailing Address - State:MS
Mailing Address - Zip Code:39482-5218
Mailing Address - Country:US
Mailing Address - Phone:017-584-6066
Mailing Address - Fax:601-758-4615
Practice Address - Street 1:MERIT HEALTH MEDICAL GROUP-SUMRALL
Practice Address - Street 2:4891 HWY 589
Practice Address - City:SUMRALL
Practice Address - State:MS
Practice Address - Zip Code:39482-3948
Practice Address - Country:US
Practice Address - Phone:601-758-4606
Practice Address - Fax:601-758-4615
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08061207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00019522Medicaid
D98378Medicare UPIN