Provider Demographics
NPI:1861484933
Name:WALKER, JOAN (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:105 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-4350
Mailing Address - Country:US
Mailing Address - Phone:318-357-2086
Mailing Address - Fax:318-521-8031
Practice Address - Street 1:1640 BREAZEALE SPRINGS ST
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-4278
Practice Address - Country:US
Practice Address - Phone:318-357-2056
Practice Address - Fax:318-521-8031
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA025544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080191197OtherRAILROAD MEDICARE
LA1577804Medicaid
LAH65990Medicare UPIN
LA1577804Medicaid