Healthcare Provider Details

I. General information

NPI: 1427028042
Provider Name (Legal Business Name): ALLISON GRAY WALKER PA - C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5408 FLANDERS DR
BATON ROUGE LA
70808-9168
US

IV. Provider business mailing address

12300 SUGAR MILL DR
GEISMAR LA
70734-3253
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-5554
  • Fax: 225-769-5502
Mailing address:
  • Phone: 225-677-9262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberA10550
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: