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General NPI Number Information
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NPI Number | 1427983774
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Entity Type | Individual
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Provider Name | WALKER NELSON PEDIGO DDS
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Gender | Male
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 772 LAKE HARBOUR DR
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City | RIDGELAND
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State | MS
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Zip | 39157-4365
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Country | US
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Telephone | 601-607-7876
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Fax |
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Provider Business Mailing Address
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Address Line | 104 GLENWOOD LN
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City | MADISON
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State | MS
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Zip | 39110-6570
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Country | US
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Telephone | 601-842-4322
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 112786
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License Number State | MS
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