Provider Demographics
NPI:1083655005
Name:BARKER, MARSHALL JAY (DO)
Entity Type:Individual
Prefix:DR
First Name:MARSHALL
Middle Name:JAY
Last Name:BARKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-1332
Mailing Address - Country:US
Mailing Address - Phone:252-747-8162
Mailing Address - Fax:252-747-8163
Practice Address - Street 1:205 MARTIN LUTHER KING JR. PARKWAY
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-1581
Practice Address - Country:US
Practice Address - Phone:252-747-4199
Practice Address - Fax:252-747-8400
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC25205207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13197OtherBCBS
NC8913197Medicaid
NC13197OtherBCBS
NC8913197Medicaid