Provider Demographics
NPI:1508074105
Name:WALKER, CRYSTAL V (MD)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:V
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:J
Other - Last Name:VLIEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 FITNESS WAY
Mailing Address - Street 2:SUITE 2700
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2480
Mailing Address - Country:US
Mailing Address - Phone:256-233-9273
Mailing Address - Fax:256-216-1920
Practice Address - Street 1:101 FITNESS WAY
Practice Address - Street 2:SUITE 2700
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2480
Practice Address - Country:US
Practice Address - Phone:256-233-9273
Practice Address - Fax:256-216-1920
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069455207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease