Provider Demographics
NPI:1053313221
Name:VAN AALST-BARKER, VERA C (MD)
Entity Type:Individual
Prefix:DR
First Name:VERA
Middle Name:C
Last Name:VAN AALST-BARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 DUPONT RD
Mailing Address - Street 2:STE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4644
Mailing Address - Country:US
Mailing Address - Phone:502-589-8000
Mailing Address - Fax:502-589-8001
Practice Address - Street 1:901 DUPONT RD
Practice Address - Street 2:STE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4644
Practice Address - Country:US
Practice Address - Phone:502-589-8000
Practice Address - Fax:502-589-8001
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY364222086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200289910Medicaid
KY64079833Medicaid
KYI06163Medicare UPIN
KY0919402Medicare ID - Type Unspecified
IN200289910Medicaid
P00223327Medicare PIN