Healthcare Provider Details

I. General information

NPI: 1487708012
Provider Name (Legal Business Name): RICHARD A WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 5TH AVE N SUITE 260
BIRMINGHAM AL
35203-1854
US

IV. Provider business mailing address

1527 5TH AVE N SUITE 260
BIRMINGHAM AL
35203-1854
US

V. Phone/Fax

Practice location:
  • Phone: 205-458-0008
  • Fax: 205-458-0011
Mailing address:
  • Phone: 205-458-0008
  • Fax: 205-458-0011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number08026
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number08026
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: