1821192931 NPI number — BARKER CHIROPRACTIC CLINIC PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821192931 NPI number — BARKER CHIROPRACTIC CLINIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BARKER CHIROPRACTIC CLINIC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BARKER CHIROPRACTIC SPORTS & FAMILY CLINIC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821192931
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4903 STARKEY ROAD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
ROANOKE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-776-3218
Provider Business Mailing Address Fax Number:
540-966-7192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4903 STARKEY ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
ROANOKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-776-3218
Provider Business Practice Location Address Fax Number:
540-966-7192
Provider Enumeration Date:
09/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BARKER
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
SEAN
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
540-776-3218

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0104001258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: 0104001053 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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