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General NPI Number Information
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NPI Number | 1770772923
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Entity Type | Individual
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Provider Name | MOLLIE ANN WALKER M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 04/09/2017
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Provider Practice Location Address
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Address Line | 804 CRAWFORD ST
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City | TUSKEGEE
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State | AL
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Zip | 36083-7262
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Country | US
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Telephone | 344-724-0550
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Fax | 334-724-0591
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Provider Business Mailing Address
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Address Line | 804 CRAWFORD ST
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City | TUSKEGEE
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State | AL
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Zip | 36083-7262
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Country | US
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Telephone | 344-724-0550
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Fax | 334-724-0591
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0011822
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 11822
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License Number State | AL
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