MEDICARE: MR. JAMES WYATT WALKER RPH

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	3336C0003X	Community/Retail Pharmacy	8110	LA
2	183500000X	Pharmacist	16690	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1477956183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES WYATT WALKER RPH

Provider Business Mailing Address
First Line	:	5600 ISLAND RD
Second Line	:
City	:	JARREAU
State	:	LA
Zip	:	70749-3307
Country	:	US
Telephone Number	:	225-202-5699
Fax Number	:	225-637-2855

Provider Business Practice Location Address
First Line	:	3066 LOUISIANA HWY 78
Second Line	:
City	:	LIVONIA
State	:	LA
Zip	:	70755
Country	:	US
Telephone Number	:	225-637-2356
Fax Number	:	225-637-2855

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	11/19/2020

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