Provider Demographics
NPI:1295553782
Name:WALKER, WILLIAM RAY
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:RAY
Last Name:WALKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 WE KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-6254
Mailing Address - Country:US
Mailing Address - Phone:479-709-6700
Mailing Address - Fax:479-709-6710
Practice Address - Street 1:3501 WE KNIGHT DR
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6254
Practice Address - Country:US
Practice Address - Phone:479-709-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
ARPA-1377363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant