Healthcare Provider Details

I. General information

NPI: 1194729186
Provider Name (Legal Business Name): WILLIAM THOMAS WALKER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 01/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 MEDICAL PARK CT
MOREHEAD CITY NC
28557-4346
US

IV. Provider business mailing address

306 MEDICAL PARK CT
MOREHEAD CITY NC
28557-4346
US

V. Phone/Fax

Practice location:
  • Phone: 252-247-2013
  • Fax: 252-247-7299
Mailing address:
  • Phone: 252-247-2013
  • Fax: 252-247-7299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25841
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: