Provider Demographics
NPI:1316942535
Name:WALKER, DONNA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:ANN
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 KILPATRICK BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5156
Mailing Address - Country:US
Mailing Address - Phone:318-322-4673
Mailing Address - Fax:318-322-4675
Practice Address - Street 1:3116 KILPATRICK BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5156
Practice Address - Country:US
Practice Address - Phone:318-322-4673
Practice Address - Fax:318-322-4675
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020699207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA020699OtherSTATE LICENSE NUMBER
LA830007943OtherRAILROAD MEDICARE
LA1907979Medicaid
LA1907979Medicaid
LA1907979Medicaid
LABW2611007OtherDEA
LA731627242OtherTIN
LAE65828Medicare UPIN
LA4A967Medicare ID - Type Unspecified