MEDICARE: JAMES H. WALKER,III DBA SANDY SPRINGS FAMILY PRACTICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	109572	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080006182	OTHER	SC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285854901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES H. WALKER,III DBA SANDY SPRINGS FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	PO BOX 450
Second Line	:
City	:	SANDY SPRINGS
State	:	SC
Zip	:	29677-0450
Country	:	US
Telephone Number	:	864-261-9100
Fax Number	:

Provider Business Practice Location Address
First Line	:	5304 HIGHWAY 76
Second Line	:
City	:	PENDLETON
State	:	SC
Zip	:	29670-9139
Country	:	US
Telephone Number	:	864-261-9100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES H WALKER III
Credential	:	M.D.
Telephone Number	:	864-261-9100

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	06/19/2008

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