Provider Demographics
NPI:1336674621
Name:CHARLES A. WALKER DBA WALKER PAIN MANAGEMENT CENTERS
Entity Type:Organization
Organization Name:CHARLES A. WALKER DBA WALKER PAIN MANAGEMENT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:731-644-0144
Mailing Address - Street 1:18 STONECREEK CIR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-6021
Mailing Address - Country:US
Mailing Address - Phone:731-664-4850
Mailing Address - Fax:731-644-0887
Practice Address - Street 1:18 STONECREEK CIR
Practice Address - Street 2:SUITE 103
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-6021
Practice Address - Country:US
Practice Address - Phone:731-664-4850
Practice Address - Fax:731-644-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty