Provider Demographics
NPI:1871634485
Name:WALKER, JOHN III (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:WALKER
Suffix:III
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 N CENTRAL AVE
Mailing Address - Street 2:STE 1407
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2112
Mailing Address - Country:US
Mailing Address - Phone:602-216-6900
Mailing Address - Fax:602-371-9889
Practice Address - Street 1:3550 N CENTRAL AVE
Practice Address - Street 2:STE 1407
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2112
Practice Address - Country:US
Practice Address - Phone:602-216-6900
Practice Address - Fax:602-371-9889
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3593103G00000X, 103TB0200X, 103TC0700X, 103TH0100X, 103TR0400X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ75960Medicare ID - Type Unspecified