Provider Demographics
NPI:1114926482
Name:BARKER, MONTY (MD)
Entity Type:Individual
Prefix:DR
First Name:MONTY
Middle Name:
Last Name:BARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 BURNETT DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-2941
Mailing Address - Country:US
Mailing Address - Phone:870-424-4200
Mailing Address - Fax:870-424-4327
Practice Address - Street 1:626 BURNETT DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-2941
Practice Address - Country:US
Practice Address - Phone:870-424-4200
Practice Address - Fax:870-424-4327
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN7843207Y00000X, 207YP0228X, 207YS0123X, 207YX0007X, 207YX0901X, 207YX0602X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117608001Medicaid
7189231-002OtherCIGNA
15365000000OtherQUALCHOICE
4375797OtherAETNA
5282OtherCOX HEALTH PLANS
AR53538OtherBLUE CROSS BLUE SHIELD
AR53538OtherBLUE CROSS BLUE SHIELD
15365000000OtherQUALCHOICE