Organization Active NPI

H. Carroll Walker, Jr., DDS,PA

  • Pediatric Dentistry
  • Starkville, MS
National Provider Identifier
1124209465
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
PEDO-006-74 Issued in MS
Legal business name
H. CARROLL WALKER, JR., DDS,PA
Practice address
100 Brandon Rd Ste W
Starkville, MS 39759-2571
Phone
(662) 323-9726
Fax
(662) 323-9727
NPI assigned
Nov 15, 2007
Last updated
Nov 15, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Darcy Redus
Title
Office MGR
Phone
(662) 323-9726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X PEDO-006-74 MS Primary

Addresses

Primary practice location

100 Brandon Rd Ste W
Starkville, MS 39759-2571

Mailing address

100 Brandon Rd Ste W
Starkville, MS 39759-2571
Phone (662) 323-9726

Other identifiers 1

IdentifierTypeStateIssuer
09205284MedicaidMS

National Provider Directory

National Provider Directory

Locations

100 Brandon Rd
Ste W
Starkville, MS 39759
Phone (662) 323-9726

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1124209465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BRANDON RD STE W",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592571",
            "telephone_number": "662-323-9726",
            "fax_number": "662-323-9727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BRANDON RD STE W",
            "city": "STARKVILLE",
            "state": "MS",
            "postal_code": "397592571",
            "telephone_number": "662-323-9726",
            "fax_number": "662-323-9727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. CARROLL WALKER, JR., DDS,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "REDUS",
        "authorized_official_first_name": "DARCY",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "662-323-9726",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MS",
            "license": "PEDO-006-74",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09205284",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Starkville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.