Provider Demographics
NPI:1235271479
Name:WALKER, JAMES C (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
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 1:2312 E MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4064
Mailing Address - Country:US
Mailing Address - Phone:337-364-9681
Mailing Address - Fax:337-367-9697
Practice Address - Street 1:2312 E MAIN ST
Practice Address - Street 2:ST. A ST.
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4064
Practice Address - Country:US
Practice Address - Phone:337-364-9681
Practice Address - Fax:337-367-9697
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17783207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1363332Medicaid
LA5CA97Medicare PIN
LA1363332Medicaid