Provider Demographics
NPI:1760457717
Name:WALKER, E EARL (MD)
Entity Type:Individual
Prefix:DR
First Name:E
Middle Name:EARL
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 1:2415 HELTON DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1067
Mailing Address - Country:US
Mailing Address - Phone:256-766-8550
Mailing Address - Fax:256-766-8002
Practice Address - Street 1:2415 HELTON DR
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1067
Practice Address - Country:US
Practice Address - Phone:256-766-8550
Practice Address - Fax:256-766-8002
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7886174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000005747Medicaid
AL411013546OtherMEDICARE RAILRAOD
AL05747OtherBCBS OF ALABAMA
AL411013546OtherMEDICARE RAILRAOD
AL000005747Medicaid