MEDICARE: DR. FLOURNOY COLZEY WALKER III M.D.

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	207Q00000X	Family Medicine Physician	8193	SC

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	:	1598878001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLOURNOY COLZEY WALKER III M.D.

Provider Business Mailing Address
First Line	:	9313 MEDICAL PLAZA DR
Second Line	:	SUITE 302
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-9155
Country	:	US
Telephone Number	:	843-553-0484
Fax Number	:	843-569-1556

Provider Business Practice Location Address
First Line	:	9313 MEDICAL PLAZA DR
Second Line	:	SUITE 302
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-9155
Country	:	US
Telephone Number	:	843-553-0484
Fax Number	:	843-569-1556

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	03/26/2015

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