Provider Demographics
NPI:1043301682
Name:BARKER, SAMUEL HARRISON (DC, NP-C)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:HARRISON
Last Name:BARKER
Suffix:
Gender:M
Credentials:DC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 WASHINGTON ST N STE 400
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3874
Mailing Address - Country:US
Mailing Address - Phone:208-734-0000
Mailing Address - Fax:208-735-5053
Practice Address - Street 1:844 WASHINGTON ST N STE 400
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3874
Practice Address - Country:US
Practice Address - Phone:208-734-0000
Practice Address - Fax:208-735-5053
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1210111N00000X
NV822860363LF0000X
IDNP-1452A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V11424Medicare UPIN
1671221Medicare Oscar/Certification