Individual
SAMUEL WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCCSSS
Contact information
Practice address
1600 BROAD AVE, GULFPORT, MS 39501-3603
(228) 213-5888
(228) 575-3433
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
(601) 705-1901
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
4138
MS
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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