Provider Demographics
NPI:1144360785
Name:WALKER, CHARLES ALLEN (MD, DAAPM)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALLEN
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD, DAAPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-4221
Mailing Address - Country:US
Mailing Address - Phone:731-644-0144
Mailing Address - Fax:731-644-0887
Practice Address - Street 1:707 E WOOD ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4221
Practice Address - Country:US
Practice Address - Phone:731-644-0144
Practice Address - Fax:731-644-0887
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000017178207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0503996OtherCIGNA PROVIDER NUMBER
TN3015336OtherBLUE CROSS PROVIDER NUMBE
TN44D0944207OtherCLIA NUMBER
TN621649945OtherTAX ID
TN5004078OtherTLC PROVIDER NUMBER
TN5785037OtherAETNA PROVIDER NUMBER
TNMD0000017178OtherSTATE OF TN LICENSE
TN010065755OtherRAILROAD MEDICARE PROVIDE
TN010065755OtherRAILROAD MEDICARE PROVIDE
TN5004078OtherTLC PROVIDER NUMBER
TN3023415Medicare ID - Type Unspecified