Provider Demographics
NPI:1023013281
Name:BARKER, WAYNE S (DDS, FACP)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:S
Last Name:BARKER
Suffix:
Gender:M
Credentials:DDS, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 POINT MEADOWS DR
Mailing Address - Street 2:STE 4
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9180
Mailing Address - Country:US
Mailing Address - Phone:904-645-6457
Mailing Address - Fax:904-645-6459
Practice Address - Street 1:7740 POINT MEADOWS DR
Practice Address - Street 2:STE 4
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9180
Practice Address - Country:US
Practice Address - Phone:904-645-6457
Practice Address - Fax:904-645-6459
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN114231223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics