Provider Demographics
NPI:1922250489
Name:WALKER, THOMAS JUERGEN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JUERGEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1280
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4792
Mailing Address - Country:US
Mailing Address - Phone:404-257-1589
Mailing Address - Fax:
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD STE 1280
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4792
Practice Address - Country:US
Practice Address - Phone:404-257-1589
Practice Address - Fax:404-257-7409
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70789207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery