Provider Demographics
NPI:1477534147
Name:WALKER, JAMES R (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:WALKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 S SAINT JOHN ST
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3413
Mailing Address - Country:US
Mailing Address - Phone:318-628-7992
Mailing Address - Fax:318-628-7997
Practice Address - Street 1:207 S SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3413
Practice Address - Country:US
Practice Address - Phone:318-628-7992
Practice Address - Fax:318-628-7997
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA875-100T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA21308OtherBLUE CROSS BLUE SHIELD
LA1304433Medicaid
LA0358730001Medicare NSC
LA21308OtherBLUE CROSS BLUE SHIELD
LAT19648Medicare UPIN