Provider Demographics
NPI:1457362568
Name:WALKER FAMILY HEALTHCARE, LLC
Entity Type:Organization
Organization Name:WALKER FAMILY HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:478-988-8556
Mailing Address - Street 1:1019 KEITH DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-4951
Mailing Address - Country:US
Mailing Address - Phone:478-988-8556
Mailing Address - Fax:478-988-9071
Practice Address - Street 1:1019 KEITH DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-4951
Practice Address - Country:US
Practice Address - Phone:478-988-8556
Practice Address - Fax:478-988-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032834207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADD5355OtherRAILROAD MEDICARE
GADD5355OtherRAILROAD MEDICARE