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NPI Code Detail

MEDICARE: DR. DANIEL JOSEPH WALKER I DMIN

MEDICARE: DR. DANIEL JOSEPH WALKER I DMIN
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
1101YM0800XMental Health Counselor4012TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14012OTHERTNLPC

General Provider Information

NPI Number : 1912426214
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL JOSEPH WALKER I DMIN
Provider Business Mailing Address
First Line : 2200 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3874
Country : US
Telephone Number : 423-599-9347
Fax Number : 832-369-7679
Provider Business Practice Location Address
First Line : 2200 CHAMBLISS AVE NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37311-3874
Country : US
Telephone Number : 423-599-9347
Fax Number : 832-369-7679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2017
Last Update Date : 09/18/2017

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