Provider Demographics
NPI:1003870031
Name:BARKWAY, LAURIE A (DO)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:A
Last Name:BARKWAY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:517-423-4777
Mailing Address - Fax:517-423-7257
Practice Address - Street 1:6869 S OCCIDENTAL RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-9784
Practice Address - Country:US
Practice Address - Phone:517-423-4777
Practice Address - Fax:517-423-7257
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101008900207P00000X, 207Q00000X
MILB008900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1003870031Medicaid
MI4634313Medicaid
MI0154600205OtherBC BS OF MI
MION95070002Medicare ID - Type Unspecified
MI0154600205OtherBC BS OF MI
MIE33197Medicare UPIN