Provider Demographics
NPI:1023101698
Name:DRS. TATUM AND WALKER, L.L.C.
Entity type:Organization
Organization Name:DRS. TATUM AND WALKER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:334-365-9732
Mailing Address - Street 1:597 SOUTH MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066
Mailing Address - Country:US
Mailing Address - Phone:334-365-9732
Mailing Address - Fax:334-365-9328
Practice Address - Street 1:597 SOUTH MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066
Practice Address - Country:US
Practice Address - Phone:334-365-9732
Practice Address - Fax:334-365-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL28281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty