Provider Demographics
NPI:1891851036
Name:WALKER, WILLIAM HARDING JR (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:HARDING
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 OLD BAY LN
Mailing Address - Street 2:
Mailing Address - City:MATHEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23109-2212
Mailing Address - Country:US
Mailing Address - Phone:804-725-9518
Mailing Address - Fax:
Practice Address - Street 1:74 OLD BAY LN
Practice Address - Street 2:
Practice Address - City:MATHEWS
Practice Address - State:VA
Practice Address - Zip Code:23109-2212
Practice Address - Country:US
Practice Address - Phone:804-725-9518
Practice Address - Fax:804-435-8667
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202005144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202005144OtherPHARMACIST LICENSE NUMBER