Provider Demographics
NPI:1154449783
Name:BARKLEY, JOHN ELDRIDGE (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ELDRIDGE
Last Name:BARKLEY
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:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5003 HOSPICE LN
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-5784
Practice Address - Country:US
Practice Address - Phone:704-935-9434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600447207R00000X, 207RC0200X, 207RP1001X, 207RH0002X, 207RP1001X, 207RH0002X
SC20639207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC13179OtherBLUE CROSS BLUE SHIELD
SCN00447Medicaid
NC1154449783Medicaid
NC8913179Medicaid
SCN00447Medicaid
2232083BMedicare PIN
NC13179OtherBLUE CROSS BLUE SHIELD
F71437Medicare UPIN