Provider Demographics
NPI:1316236235
Name:WALKER, HAMPTON EUGENE JR (PHD)
Entity type:Individual
Prefix:DR
First Name:HAMPTON
Middle Name:EUGENE
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:204 W GRAND RIVER AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2250
Mailing Address - Country:US
Mailing Address - Phone:517-540-6166
Mailing Address - Fax:517-518-8829
Practice Address - Street 1:204 W GRAND RIVER AVE STE 260
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2250
Practice Address - Country:US
Practice Address - Phone:517-540-6166
Practice Address - Fax:517-540-6166
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006503103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1316236235Other453751358
MI1316236235Medicaid