Healthcare Provider Details

I. General information

NPI: 1306840194
Provider Name (Legal Business Name): JAMES H WALKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 JOEL DR
FORT CAMPBELL KY
42223-5318
US

IV. Provider business mailing address

134 TARA LN
GOODLETTSVILLE TN
37072-8427
US

V. Phone/Fax

Practice location:
  • Phone: 540-968-6564
  • Fax:
Mailing address:
  • Phone: 540-968-6564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number52011
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: