Provider Demographics
NPI:1235238825
Name:BARKAN, DAWN M (OD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:BARKAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11665 ASCOT LN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-9340
Mailing Address - Country:US
Mailing Address - Phone:440-622-1064
Mailing Address - Fax:
Practice Address - Street 1:24801 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3487
Practice Address - Country:US
Practice Address - Phone:440-979-9546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5012 T1889152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0978036Medicaid
OH0895431Medicare PIN
OHU77967Medicare UPIN