Provider Demographics
NPI:1518165547
Name:BARKLEY, LEX DOUGLAS (BS, OD)
Entity Type:Individual
Prefix:DR
First Name:LEX
Middle Name:DOUGLAS
Last Name:BARKLEY
Suffix:
Gender:M
Credentials:BS, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2456 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-4310
Mailing Address - Country:US
Mailing Address - Phone:901-494-6942
Mailing Address - Fax:
Practice Address - Street 1:3295 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-4690
Practice Address - Country:US
Practice Address - Phone:901-324-2122
Practice Address - Fax:901-324-2828
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1295152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist