Provider Demographics
NPI:1427028042
Name:WALKER, ALLISON GRAY (PA - C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:GRAY
Last Name:WALKER
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12300 SUGAR MILL DR
Mailing Address - Street 2:
Mailing Address - City:GEISMAR
Mailing Address - State:LA
Mailing Address - Zip Code:70734-3253
Mailing Address - Country:US
Mailing Address - Phone:225-677-9262
Mailing Address - Fax:
Practice Address - Street 1:5408 FLANDERS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-9168
Practice Address - Country:US
Practice Address - Phone:225-769-5554
Practice Address - Fax:225-769-5502
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAA10550208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CC94P565Medicare ID - Type Unspecified