Provider Demographics
NPI:1255442539
Name:WALKER, CARL D JR (M D)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:D
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PERDIDO ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1393
Mailing Address - Country:US
Mailing Address - Phone:504-568-2259
Mailing Address - Fax:
Practice Address - Street 1:1816 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-2314
Practice Address - Country:US
Practice Address - Phone:504-366-7638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017885207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1900109Medicaid
LA1900109Medicaid
LA5N050Medicare ID - Type Unspecified