Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 11433 | MS |
NPI | 1316983620 |
---|---|
Provider Name | Rosalyn C Walker |
First Address | Jackson, MS 39216-4538 |
Second Address | Jackson, MS 39216-4538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 14/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00116555 | (05) | MS |
1677728 | (05) | LA |
E34475 | (02) | MS |