Basic Information
| Provider Information | |||||||||
| NPI: | 1306840194 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WALKER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 457 | ||||||||
| Address2: | 5 E ALVON ROAD, SUITE 7 | ||||||||
| City: | WHITE SULPHUR SPRINGS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249862373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045365030 | ||||||||
| FaxNumber: | 3045365051 | ||||||||
| Practice Location | |||||||||
| Address1: | 2419 VALLEY RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | COVINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244266381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408638736 | ||||||||
| FaxNumber: | 5408638750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2005 | ||||||||
| LastUpdateDate: | 01/05/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101226549 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 005600723 | 05 | VA | MEDICAID | 1805115000 | 05 | WV | MEDICAID |