Provider Demographics
NPI:1700028743
Name:BARKLEY, LAURA ELIZABETH
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELIZABETH
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 SPRING ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3704
Mailing Address - Country:US
Mailing Address - Phone:812-283-5950
Mailing Address - Fax:812-285-5439
Practice Address - Street 1:550 S JACKSON ST
Practice Address - Street 2:ACB 3RD FLOOR
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1622
Practice Address - Country:US
Practice Address - Phone:502-819-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075396A2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN121210007Medicare PIN