Healthcare Provider Details

I. General information

NPI: 1427236165
Provider Name (Legal Business Name): WALKER ORTHODONTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTH UNIVERSITY SUITE 200
LITTLE ROCK AR
72116
US

IV. Provider business mailing address

PO BOX 241892
LITTLE ROCK AR
72223-0016
US

V. Phone/Fax

Practice location:
  • Phone: 501-812-6900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3244 (0094)
License Number StateAR

VIII. Authorized Official

Name: DR. DAVID EARL WALKER
Title or Position: DOCTOR
Credential:
Phone: 501-812-6900