Basic Information
| Provider Information | |||||||||
| NPI: | 1962475749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1121 BELLEVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | BREWTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 364261500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2518676071 | ||||||||
| FaxNumber: | 2518675999 | ||||||||
| Practice Location | |||||||||
| Address1: | 1121 BELLEVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | BREWTON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 364261505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2518093170 | ||||||||
| FaxNumber: | 2518675999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 14004 | AL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 512-43312 | 01 | AL | BCBS OF AL | OTHER | 251758 | 05 | AL | MEDICAID | 000080017 | 05 | AL | MEDICAID |