Provider Demographics
NPI:1770551368
Name:WALKER, WILLIAM A (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10810 PARKSIDE DR STE 208
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-1981
Mailing Address - Country:US
Mailing Address - Phone:865-647-3350
Mailing Address - Fax:865-647-3359
Practice Address - Street 1:10810 PARKSIDE DR STE 208
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-1981
Practice Address - Country:US
Practice Address - Phone:865-647-3350
Practice Address - Fax:865-647-3359
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN140572086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3002187Medicaid
TN3002187Medicaid
TN103I025027Medicare PIN