Provider Demographics
NPI:1811502560
Name:WALKER, LOUIS JAMES III
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:JAMES
Last Name:WALKER
Suffix:III
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 1:4420 DIXIE HWY STE 122
Mailing Address - Street 2:
Mailing Address - City:SHIVELY
Mailing Address - State:KY
Mailing Address - Zip Code:40216-2986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4420 DIXIE HWY STE 122
Practice Address - Street 2:
Practice Address - City:SHIVELY
Practice Address - State:KY
Practice Address - Zip Code:40216-2986
Practice Address - Country:US
Practice Address - Phone:502-447-2750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist