1427632637 NPI number — DR. LAUREN ELIZABETH BARKER OD

Table of content: DR. LAUREN ELIZABETH BARKER OD (NPI 1427632637)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427632637 NPI number — DR. LAUREN ELIZABETH BARKER OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARKER
Provider First Name:
LAUREN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WEISGARBER
Provider Other First Name:
LAUREN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427632637
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1213 RUSSELL DR NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOLIVAR
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44612-8418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-316-3219
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
707 N WOOSTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOVER
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44622-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-365-2020
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/12/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OPT.006976 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)