Provider Demographics
NPI:1780768630
Name:WALKER, PATRICK DECOURCY (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:DECOURCY
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:827 BAYOU GARDENS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-1464
Mailing Address - Country:US
Mailing Address - Phone:985-853-2343
Mailing Address - Fax:985-853-0589
Practice Address - Street 1:827 BAYOU GARDENS BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70364-1464
Practice Address - Country:US
Practice Address - Phone:985-853-2343
Practice Address - Fax:985-853-0589
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14187R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1101630Medicaid
LA4A551CB56Medicare PIN
LA1101630Medicaid