Provider Demographics
NPI:1487640033
Name:WALKER, WILLIAM S (NP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:WALKER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47501-0760
Mailing Address - Country:US
Mailing Address - Phone:812-254-7310
Mailing Address - Fax:812-257-8062
Practice Address - Street 1:421 E VAN TREES ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IN
Practice Address - Zip Code:47501-2948
Practice Address - Country:US
Practice Address - Phone:812-254-2663
Practice Address - Fax:812-257-7075
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001830A363LF0000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200520250AMedicaid
IN000000372944OtherANTHEM
IN200520250AMedicaid
INCH1472Medicare PIN
IN000000372944OtherANTHEM