Individual
CLINTON WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Mailing address
2500 NORTH STATE STREET, JACKSON, MS 39216-4500
(601) 815-4778
(601) 984-5420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R886071
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04706763
—
MS
Enumeration date
01/20/2015
Last updated
10/13/2016
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