Provider Demographics
NPI:1639258254
Name:WALKER, SAMUEL PATRICK SR (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:PATRICK
Last Name:WALKER
Suffix:SR
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:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:AL
Mailing Address - Zip Code:36049-0407
Mailing Address - Country:US
Mailing Address - Phone:334-335-6515
Mailing Address - Fax:334-335-2105
Practice Address - Street 1:39 ROY BEALL DR
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-6805
Practice Address - Country:US
Practice Address - Phone:334-335-6515
Practice Address - Fax:334-335-2105
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6744207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine