Provider Demographics
NPI:1154924231
Name:WALKER, WILLIAM THOMAS (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
Last Name:WALKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:T
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:5628 SAPPHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-2311
Mailing Address - Country:US
Mailing Address - Phone:317-727-5284
Mailing Address - Fax:
Practice Address - Street 1:5628 SAPPHIRE DR
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-2311
Practice Address - Country:US
Practice Address - Phone:317-727-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018361A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist