Healthcare Provider Details

I. General information

NPI: 1023201258
Provider Name (Legal Business Name): WALKER WOMENS SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 12/04/2024
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BLACKWELL DAIRY ROAD
JASPER AL
35504
US

IV. Provider business mailing address

304 BLACKWELL DAIRY ROAD
JASPER AL
35504
US

V. Phone/Fax

Practice location:
  • Phone: 205-384-4801
  • Fax: 205-384-4538
Mailing address:
  • Phone: 205-384-4801
  • Fax: 205-384-4538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAL28185
License Number StateAL

VIII. Authorized Official

Name: MS. LINDA MARIE THALER
Title or Position: OFFICE MANAGER
Credential:
Phone: 205-384-4801