Provider Demographics
NPI:1306840194
Name:WALKER, JAMES H (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
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:PO BOX 457
Mailing Address - Street 2:5 E ALVON ROAD, SUITE 7
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-2373
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5051
Practice Address - Street 1:2419 VALLEY RIDGE RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:VA
Practice Address - Zip Code:24426-6381
Practice Address - Country:US
Practice Address - Phone:540-863-8736
Practice Address - Fax:540-863-8750
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005600723Medicaid
WV1805115000Medicaid
VA080007313Medicare ID - Type UnspecifiedTRAILBLAZER HEALTH/VAMC
WV1805115000Medicaid
VA005600723Medicaid