Provider Demographics
NPI:1114929320
Name:BARKER, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
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 1:33 W RAHN RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2219
Mailing Address - Country:US
Mailing Address - Phone:937-433-8990
Mailing Address - Fax:937-433-8691
Practice Address - Street 1:33 W RAHN RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2219
Practice Address - Country:US
Practice Address - Phone:937-433-8990
Practice Address - Fax:937-433-8691
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044402B207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0508123Medicaid
OH0508123Medicaid
OHC01809Medicare UPIN