Provider Demographics
NPI:1235132382
Name:WALKER, WILLIAM MARTIN (O D)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARTIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S COX ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5717
Mailing Address - Country:US
Mailing Address - Phone:336-625-4359
Mailing Address - Fax:336-625-4291
Practice Address - Street 1:402 S COX ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5717
Practice Address - Country:US
Practice Address - Phone:336-625-4359
Practice Address - Fax:336-625-4291
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1158152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1158OtherSTATE LICENSE NUMBER
NC8909941Medicaid
NC4879070001Medicare NSC
NC8909941Medicaid