Provider Demographics
NPI:1639519762
Name:WALKER COMPREHENSIVE PAIN CENTER, PC
Entity Type:Organization
Organization Name:WALKER COMPREHENSIVE PAIN CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-386-2051
Mailing Address - Street 1:PO BOX 1427
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35502-1427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 20
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3425
Practice Address - Country:US
Practice Address - Phone:205-221-5374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty