Provider Demographics
NPI:1649391145
Name:WALKER, BENJAMIN ISAIAH III (ARNP, DC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ISAIAH
Last Name:WALKER
Suffix:III
Gender:M
Credentials:ARNP, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16171 RAMBLING VINE DR E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1196
Mailing Address - Country:US
Mailing Address - Phone:813-961-1712
Mailing Address - Fax:
Practice Address - Street 1:16171 RAMBLING VINE DR E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1196
Practice Address - Country:US
Practice Address - Phone:813-961-1712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6247111N00000X
FL9307392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor