Provider Demographics
NPI:1417252818
Name:PRICE WALKER JR. M.D.P.C.
Entity Type:Organization
Organization Name:PRICE WALKER JR. M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:706-322-6890
Mailing Address - Street 1:1013 TALBOTTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8744
Mailing Address - Country:US
Mailing Address - Phone:706-322-6890
Mailing Address - Fax:706-322-8361
Practice Address - Street 1:1013 TALBOTTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-8744
Practice Address - Country:US
Practice Address - Phone:706-322-6890
Practice Address - Fax:706-322-8361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021065332900000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000269519DMedicaid
GA1167000001Medicare NSC