Provider Demographics
NPI:1013998624
Name:WALKER, HOWARD S (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:S
Last Name:WALKER
Suffix:
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:PO BOX 9391
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-0391
Mailing Address - Country:US
Mailing Address - Phone:251-544-1926
Mailing Address - Fax:251-460-0328
Practice Address - Street 1:3715 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1774
Practice Address - Country:US
Practice Address - Phone:251-544-1926
Practice Address - Fax:251-460-0328
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7177174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051554184Medicaid
AL051554184OtherBC BS
A27836Medicare UPIN
AL051554184Medicaid