Active NPI
Edgar Alfred Walker Jr., M.D.
- Child & Adolescent Psychiatry Physician
- Leesburg, FL
National Provider Identifier
1396898177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- ME100266
- Practice address
- 215 N 3Rd St
Leesburg, FL 34748-5105 - Phone
- (352) 315-7500
- Fax
- (352) 360-6582
- NPI assigned
- Jan 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | ME100266 | FL | Primary |
Addresses
Primary practice location
215 N 3Rd St
Leesburg, FL 34748-5105
Mailing address
PO Box 491000
Leesburg, FL 34749-1000
Phone (352) 315-7500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000252200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME100266 | FL | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323820800000",
"number": "1396898177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 491000",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347491000",
"telephone_number": "352-315-7500",
"fax_number": "352-360-6582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 N 3RD ST",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485105",
"telephone_number": "352-315-7500",
"fax_number": "352-360-6582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "EDGAR",
"middle_name": "ALFRED",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2011-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "FL",
"license": "ME100266",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000252200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leesburg, FL
- Wal-Mart Stores East LP (Walmart Pharmacy 10-0800)
- Wal-Mart Stores East, LP (Vision Center 30-0800)
- Walgreen Co (Walgreens #06163)
- Walgreen Co (Walgreens #06940)
- Walgreen Co (Walgreens #06887)
- Jercoby Demin Walker
- Kevin Bruce Wallace, D.M.D.
- Richard B Wallace, D.O.
- Lindsey Marie Walsh
- Nicholas Ward, RBT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.