Individual
DEONTAY WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
247 S MAIN ST, REIDSVILLE, GA 30453-4605
(516) 945-3000
(704) 248-5537
Mailing address
PO BOX 945375, ATLANTA, GA 30394-5375
(516) 945-3000
(704) 248-5537
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
12599
GA
367H00000X
Anesthesiologist Assistant
67.000424
OH
Other
Enumeration date
09/17/2021
Last updated
12/04/2024
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