Provider Demographics
NPI:1760439020
Name:WALKER, JAMES KENDALL (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:KENDALL
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 1:9784 N ASH AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-9742
Mailing Address - Country:US
Mailing Address - Phone:816-781-4244
Mailing Address - Fax:816-781-3542
Practice Address - Street 1:9784 N ASH AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157-9742
Practice Address - Country:US
Practice Address - Phone:816-781-4244
Practice Address - Fax:816-781-3542
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001023416207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208830802Medicaid
MOH71526Medicare UPIN
N23C512Medicare PIN