MEDICARE: CAROLYN HILL WALKER DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	41395	CA
2	225100000X	Physical Therapist	PT4925	MS

General Provider Information

NPI Number	:	1659788347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN HILL WALKER DPT

Provider Business Mailing Address
First Line	:	199 N BROOKMOORE DR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2024
Country	:	US
Telephone Number	:	662-327-6705
Fax Number	:	662-327-6760

Provider Business Practice Location Address
First Line	:	204 ENTERPRISE DR
Second Line	:
City	:	OXFORD
State	:	MS
Zip	:	38655-2761
Country	:	US
Telephone Number	:	662-234-0010
Fax Number	:	662-234-0017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/11/2019

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