Healthcare Provider Details

I. General information

NPI: 1245809060
Provider Name (Legal Business Name): MATTHEW GARRETT WALKER DNP, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 CENTER ST
COLUMBUS GA
31901-1527
US

IV. Provider business mailing address

8514 CONDUIT ST
MONTGOMERY AL
36116-6840
US

V. Phone/Fax

Practice location:
  • Phone: 706-571-1000
  • Fax:
Mailing address:
  • Phone: 205-983-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberGAA-CRNA004003
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-172132
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-172132
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: