Provider Demographics
NPI:1871640946
Name:WALKER, JAMES LEE JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
Last Name:WALKER
Suffix:JR
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 1:929 N SAINT FRANCIS AVE RM 8078
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3821
Mailing Address - Country:US
Mailing Address - Phone:316-268-6147
Mailing Address - Fax:316-291-7759
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-5000
Practice Address - Fax:316-291-4272
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-4285207LC0200X
KS0432411207L00000X, 207LC0200X
NE33118207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200426170AMedicaid
KS200426170BMedicaid
KSP00679606OtherRR MEDICARE GROUP # CQ2302
KS106367OtherBCBS KS
KS106367Medicare PIN
KS200426170AMedicaid