Healthcare Provider Details

I. General information

NPI: 1295426146
Provider Name (Legal Business Name): BALEIGH ROBERTSON WALKER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 6TH AVE SE
CULLMAN AL
35055-3656
US

IV. Provider business mailing address

637 COUNTY ROAD 1462
CULLMAN AL
35055-0603
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-7151
  • Fax:
Mailing address:
  • Phone: 205-522-6498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD.007636-C1
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: