Provider Demographics
NPI:1477592145
Name:BARKER, ALLAN LESLIE MEYER (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:LESLIE MEYER
Last Name:BARKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 RIDGE LANE N.
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480
Mailing Address - Country:US
Mailing Address - Phone:252-904-1184
Mailing Address - Fax:252-451-5330
Practice Address - Street 1:9 RIDGE LANE N.
Practice Address - Street 2:
Practice Address - City:WRIGHTSVILLE BEACH
Practice Address - State:NC
Practice Address - Zip Code:28480
Practice Address - Country:US
Practice Address - Phone:252-904-1184
Practice Address - Fax:252-451-5330
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0943152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909543Medicaid
NCT64925Medicare UPIN
NC8909543Medicaid