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General NPI Number Information
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NPI Number | 1285854901
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Entity Type | Organization
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Legal Business Name | JAMES H. WALKER,III DBA SANDY SPRINGS FAMILY PRACTICE
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 5304 HIGHWAY 76
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City | PENDLETON
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State | SC
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Zip | 29670-9139
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Country | US
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Telephone | 864-261-9100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 450
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City | SANDY SPRINGS
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State | SC
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Zip | 29677-0450
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Country | US
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Telephone | 864-261-9100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES H WALKER III
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Credential | M.D.
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Telephone | 864-261-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 109572
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License Number State | SC
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