Provider Demographics
NPI:1518947332
Name:WALKER, GEORGE PHILLIPS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:PHILLIPS
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1134
Mailing Address - Country:US
Mailing Address - Phone:256-494-3000
Mailing Address - Fax:256-494-3015
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 202
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1134
Practice Address - Country:US
Practice Address - Phone:256-494-3000
Practice Address - Fax:256-494-3015
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL3279208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL20-2383599OtherTAX ID NUMBER
ALC76525Medicare UPIN