Provider Demographics
NPI:1275553851
Name:WALKER, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1701 WESTCHESTER DRIVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:624 QUAKER LN
Practice Address - Street 2:SUITE 105C
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3832
Practice Address - Country:US
Practice Address - Phone:336-802-2105
Practice Address - Fax:336-802-2106
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2002-01323207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132WMMedicaid
NC100016836OtherRR MEDICARE
2009140Medicare ID - Type Unspecified
F53012Medicare UPIN