Provider Demographics
NPI:1487708012
Name:WALKER, RICHARD A (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 5TH AVE N
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-1854
Mailing Address - Country:US
Mailing Address - Phone:205-458-0008
Mailing Address - Fax:205-458-0011
Practice Address - Street 1:1527 5TH AVE N
Practice Address - Street 2:SUITE 260
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35203-1854
Practice Address - Country:US
Practice Address - Phone:205-458-0008
Practice Address - Fax:205-458-0011
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL08026207KA0200X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000010614Medicaid
ALC78671Medicare UPIN