Provider Demographics
NPI:1821169913
Name:WALKER, MARION STEVEN I (DC)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:STEVEN
Last Name:WALKER
Suffix:I
Gender:M
Credentials:DC
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 881
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-0881
Mailing Address - Country:US
Mailing Address - Phone:478-994-1562
Mailing Address - Fax:478-994-1580
Practice Address - Street 1:255 TIFT COLLEGE DR
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2324
Practice Address - Country:US
Practice Address - Phone:478-994-1562
Practice Address - Fax:478-994-1580
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1857111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-1493972OtherEIN
GA58-1493972OtherEIN