Charles Osborne Walker Jr., MD
Individual provider Active NPI Surgery Physician · Donalsonville, GA
NPI 1851398366 · NPPES record last updated Oct 6, 2009
Key facts
- NPI
- 1851398366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 009288 (GA)
- Practice address
- 804 N Wiley Ave
Donalsonville, GA 39845-1120 - Phone
- (229) 524-2706
- Fax
- (229) 524-2738
- NPI assigned
- Jun 30, 2005
- Reactivated
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061122000003 | GA | Practitioner - General Surgery |
5698773836 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009288 | GA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Wiregrass Medical & Surgical Group Inc | Family Medicine | Current |
Accepting new patients |
Locations
804 N Wiley Ave
Donalsonville, GA 39845
Phone (229) 524-2808
Interoperability endpoints
- charles.walker@gadirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 009288 | GA | Yes |
| Family Medicine Physician | 207Q00000X | 9288 | GA |
Addresses
Primary practice location
804 N Wiley Ave
Donalsonville, GA 39845-1120
Mailing address
804 N Wiley Ave
Donalsonville, GA 39845-1120
Phone (229) 524-2706
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000019324B | Medicaid | GA | |
| 581365608 | Other | GA | CHARLES O WALKER MD PC |
| 20-5308117 | Other | GA | THE WIREGRASS MEDICAL & S |
Other providers in Donalsonville, GA
- Haley Melissa Tiner
- Eve H Trawick
- Tri-State Home Medical
- V E Health Services LLC
- Walgreen Co
- Joseph Lynn Walker
- Wayz2G0 Nemt LLC
- Haley Weaver
- Billy C. Williams
- Shakedia Williams
All providers in Donalsonville, GA · Surgery Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.