Provider Demographics
NPI:1417384579
Name:BARKER, DAVID NICHOLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NICHOLAS
Last Name:BARKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 NICHOLAS RD
Mailing Address - Street 2:
Mailing Address - City:JEROME
Mailing Address - State:ID
Mailing Address - Zip Code:83338-5511
Mailing Address - Country:US
Mailing Address - Phone:208-670-0093
Mailing Address - Fax:
Practice Address - Street 1:523 NICHOLAS RD
Practice Address - Street 2:
Practice Address - City:JEROME
Practice Address - State:ID
Practice Address - Zip Code:83338-5511
Practice Address - Country:US
Practice Address - Phone:208-670-0093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist