Provider Demographics
NPI:1912963695
Name:WALKER, RICHARD WILLIAM (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
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 1:3000 RAEFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-5442
Mailing Address - Country:US
Mailing Address - Phone:910-483-7704
Mailing Address - Fax:910-483-2799
Practice Address - Street 1:3000 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5442
Practice Address - Country:US
Practice Address - Phone:910-483-7704
Practice Address - Fax:910-483-2799
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7908968Medicaid
NC330683OtherUHC/CIGNA
08968OtherBCBS
NC2446309AMedicare ID - Type Unspecified