Provider Demographics
NPI:1396866943
Name:WALKER, JOSEPH LYNN (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LYNN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:804 N WILEY AVE
Mailing Address - Street 2:WIREGRASS MEDICAL AND SURGICAL GROUP
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1120
Mailing Address - Country:US
Mailing Address - Phone:229-524-2706
Mailing Address - Fax:
Practice Address - Street 1:804 N WILEY AVE
Practice Address - Street 2:WIREGRASS MEDICAL AND SURGICAL GROUP
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1120
Practice Address - Country:US
Practice Address - Phone:229-524-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000354208600000X
NY249266208600000X
GA060890208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery