Healthcare Provider Details

I. General information

NPI: 1104070390
Provider Name (Legal Business Name): JOSEPH SETH WALKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CARRAWAY DR STE B2
WINFIELD AL
35594-5072
US

IV. Provider business mailing address

PO BOX 726
WINFIELD AL
35594-0726
US

V. Phone/Fax

Practice location:
  • Phone: 205-487-7661
  • Fax: 877-915-6502
Mailing address:
  • Phone: 205-487-7661
  • Fax: 877-915-6502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number30101
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: