Provider Demographics
NPI:1457650269
Name:WALKER, JOHN WALTER (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WALTER
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:WALTER
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1601 E NAPOLEON ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:LA
Mailing Address - Zip Code:70663-3654
Mailing Address - Country:US
Mailing Address - Phone:337-626-9212
Mailing Address - Fax:337-626-9047
Practice Address - Street 1:1601 E NAPOLEON ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:LA
Practice Address - Zip Code:70663-3654
Practice Address - Country:US
Practice Address - Phone:337-626-9212
Practice Address - Fax:337-626-9047
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9470183500000X
TX19842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist