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Individual

JIMMY ALLEN WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1237 MCDONALD CHAPEL RD, COLLINS, MS 39428-4094
(601) 765-0002
(601) 765-0003
Mailing address
PO BOX 755, COLLINS, MS 39428-0755
(601) 765-0002
(601) 765-0003

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
588
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00116671
MS
Enumeration date
07/27/2006
Last updated
07/08/2007
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