Provider Demographics
NPI:1245240423
Name:WALKER, DAVID ARDEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ARDEN
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 1:850 W 3RD NORTH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3887
Mailing Address - Country:US
Mailing Address - Phone:423-581-2795
Mailing Address - Fax:423-289-1605
Practice Address - Street 1:850 W 3RD NORTH ST
Practice Address - Street 2:SUITE B
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3887
Practice Address - Country:US
Practice Address - Phone:423-581-2795
Practice Address - Fax:423-289-1605
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDO14137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3194263Medicaid
TN3194263Medicare ID - Type Unspecified
TN3194263Medicaid