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General NPI Number Information
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NPI Number | 1265495576
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Entity Type | Individual
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Provider Name | LEONARD ANDERSON WALKER III MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 08/06/2017
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Provider Practice Location Address
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Address Line | 5655 FRIST BLVD
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City | HERMITAGE
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State | TN
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Zip | 37076-2053
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Country | US
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Telephone | 615-316-3541
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Fax |
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Provider Business Mailing Address
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Address Line | 2905 BLUE TEAL LANE
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City | SIGNAL MOUNTAIN
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State | TN
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Zip | 37377
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Country | US
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Telephone | 423-475-6896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20690
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | MD00020690
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD0000020690
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License Number State | TN
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