Healthcare Provider Details
I. General information
NPI: 1104005677
Provider Name (Legal Business Name): SONYA WALKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2007
Last Update Date: 06/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
910 ADAMS ST SE STE 220
HUNTSVILLE AL
35801-3730
US
IV. Provider business mailing address
910 ADAMS ST SE STE 220
HUNTSVILLE AL
35801-3730
US
V. Phone/Fax
- Phone: 256-265-1800
- Fax: 256-265-1801
- Phone: 256-265-1800
- Fax: 256-265-1801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | 30485 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: