Provider Demographics
NPI:1083387732
Name:BARKER, STEVEN JAMES JR (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:BARKER
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 SE 44TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-3246
Mailing Address - Country:US
Mailing Address - Phone:352-239-3000
Mailing Address - Fax:
Practice Address - Street 1:5360 S 2700 W
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84129-1524
Practice Address - Country:US
Practice Address - Phone:801-996-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT12543868-1206363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT12543868-1206OtherUTAH PHYSICIAN ASSISTANT LICENSE