Healthcare Provider Details

I. General information

NPI: 1417252818
Provider Name (Legal Business Name): PRICE WALKER JR. M.D.P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 TALBOTTON RD
COLUMBUS GA
31904-8744
US

IV. Provider business mailing address

1013 TALBOTTON RD
COLUMBUS GA
31904-8744
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-6890
  • Fax: 706-322-8361
Mailing address:
  • Phone: 706-322-6890
  • Fax: 706-322-8361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number021065
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number021065
License Number StateGA

VIII. Authorized Official

Name: DR. PRICE WALKER JR.
Title or Position: CEO
Credential: M.D.
Phone: 706-322-6890