Provider Demographics
NPI:1467156521
Name:ANTHONY, AUSTIN WALKER
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:WALKER
Last Name:ANTHONY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2982 CANE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-7204
Mailing Address - Country:US
Mailing Address - Phone:901-378-8486
Mailing Address - Fax:
Practice Address - Street 1:2982 CANE CREEK DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7204
Practice Address - Country:US
Practice Address - Phone:901-378-8486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ207T00000X207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery