Provider Demographics
NPI:1538257175
Name:WALKER, WILLIAM SEAY II
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SEAY
Last Name:WALKER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:TIMMONSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29161-1725
Mailing Address - Country:US
Mailing Address - Phone:843-346-7511
Mailing Address - Fax:
Practice Address - Street 1:101 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIMMONSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29161-1725
Practice Address - Country:US
Practice Address - Phone:843-346-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC22171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSC2217-3Medicaid