Provider Demographics
NPI:1326361783
Name:WALKER CLINIC, LLC
Entity Type:Organization
Organization Name:WALKER CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:PEARCE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:731-225-3379
Mailing Address - Street 1:110 CEDARFIELD LANE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340
Mailing Address - Country:US
Mailing Address - Phone:731-225-3379
Mailing Address - Fax:
Practice Address - Street 1:1385 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-7525
Practice Address - Country:US
Practice Address - Phone:731-427-0470
Practice Address - Fax:731-427-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7653363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty