Provider Demographics
NPI:1275527434
Name:D. BRADFORD BARKER, MD, PLC
Entity Type:Organization
Organization Name:D. BRADFORD BARKER, MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRADFORD
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-246-6046
Mailing Address - Street 1:2333 BIDDLE ST
Mailing Address - Street 2:REHABILITATION WING
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-4668
Mailing Address - Country:US
Mailing Address - Phone:734-246-6046
Mailing Address - Fax:734-324-3618
Practice Address - Street 1:2333 BIDDLE ST
Practice Address - Street 2:REHABILITATION WING
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4668
Practice Address - Country:US
Practice Address - Phone:734-246-6046
Practice Address - Fax:734-324-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty