Healthcare Provider Details

I. General information

NPI: 1770547739
Provider Name (Legal Business Name): BHC - WALKER IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 BLACKWELL DAIRY RD
JASPER AL
35504-8406
US

IV. Provider business mailing address

302 BLACKWELL DAIRY RD
JASPER AL
35504-8406
US

V. Phone/Fax

Practice location:
  • Phone: 205-221-4770
  • Fax: 205-221-7606
Mailing address:
  • Phone: 205-221-4770
  • Fax: 205-221-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: G. SCOTT FENN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 205-715-5415