Provider Demographics
NPI:1770540015
Name:WALKER, JAMES T III (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:WALKER
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
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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:SUITE A
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2008-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA032834207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00444529DMedicaid
GA08BBVTZ GRP 4178Medicare ID - Type Unspecified
GA00444529DMedicaid