Provider Demographics
NPI:1770611568
Name:WALKER, WALTER S (DC)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:S
Last Name:WALKER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 POPLAR VIEW PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3436
Mailing Address - Country:US
Mailing Address - Phone:901-854-6200
Mailing Address - Fax:901-853-3608
Practice Address - Street 1:336 POPLAR VIEW PKWY STE 2
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3436
Practice Address - Country:US
Practice Address - Phone:901-854-6200
Practice Address - Fax:901-853-3608
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00133421OtherBLUE CROSS BLUE SIIELD
3676163Medicare ID - Type Unspecified
TN00133421OtherBLUE CROSS BLUE SIIELD