Provider Demographics
NPI:1952355802
Name:WALKER, DAVID MELVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MELVIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ZORN AVENUE
Mailing Address - Street 2:ATTN: MEDICAL STAFF OFFICE (A104E)
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206
Mailing Address - Country:US
Mailing Address - Phone:502-287-5333
Mailing Address - Fax:502-287-6263
Practice Address - Street 1:800 ZORN AVENUE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-287-5333
Practice Address - Fax:502-287-6263
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0524922084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA605272170AMedicaid
GA605272170AMedicaid
GAI48167Medicare UPIN