Healthcare Provider Details

I. General information

NPI: 1669404935
Provider Name (Legal Business Name): JAMES RANDALL WALKER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 SOUTH FIRST STREET
JACKSONVILLE AR
72075
US

IV. Provider business mailing address

707 SOUTH FIRST STREET
JACKSONVILLE AR
72075
US

V. Phone/Fax

Practice location:
  • Phone: 501-985-0292
  • Fax: 501-985-2070
Mailing address:
  • Phone: 501-985-0292
  • Fax: 501-985-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP8811020
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM9710027
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: