Provider Demographics
NPI:1013643956
Name:BARKER, WILLIS (HHA)
Entity Type:Individual
Prefix:MR
First Name:WILLIS
Middle Name:
Last Name:BARKER
Suffix:
Gender:M
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 LEE BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1268
Mailing Address - Country:US
Mailing Address - Phone:216-938-1216
Mailing Address - Fax:
Practice Address - Street 1:2490 LEE BLVD STE 311
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1404
Practice Address - Country:US
Practice Address - Phone:216-233-0590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health