Individual
SUE D WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
421 S 28TH AVE, HATTIESBURG, MS 39401-7236
(601) 579-5261
(601) 579-5257
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5261
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12894
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116241
—
MS
05
—
009924650
—
AL
01
—
1559125
AMERICAN ADMIN GROUP
MS
05
—
1561282
—
LA
Enumeration date
08/30/2006
Last updated
07/14/2020
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