Provider Demographics
NPI:1457705501
Name:WALKER, MCCALL RICHARD
Entity Type:Individual
Prefix:
First Name:MCCALL
Middle Name:RICHARD
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 INNOVATION CT STE A
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:LA
Mailing Address - Zip Code:70359-3131
Mailing Address - Country:US
Mailing Address - Phone:985-303-4100
Mailing Address - Fax:985-303-4101
Practice Address - Street 1:191 INNOVATION CT STE A
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:LA
Practice Address - Zip Code:70359-3131
Practice Address - Country:US
Practice Address - Phone:985-303-4100
Practice Address - Fax:985-303-4101
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA337018207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology