Provider Demographics
NPI:1184262297
Name:WALKER, JOHN HUFF III (NBCOT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HUFF
Last Name:WALKER
Suffix:III
Gender:M
Credentials:NBCOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N HAYDEN ST
Mailing Address - Street 2:
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-3639
Mailing Address - Country:US
Mailing Address - Phone:662-247-4446
Mailing Address - Fax:662-247-2772
Practice Address - Street 1:702 HIGHWAY 82 W STE B
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-5069
Practice Address - Country:US
Practice Address - Phone:662-455-5010
Practice Address - Fax:662-455-5468
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT3058208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation