Provider Demographics
NPI:1821039660
Name:BARKER, VINCENT B (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:B
Last Name:BARKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-3337
Mailing Address - Country:US
Mailing Address - Phone:662-369-9525
Mailing Address - Fax:
Practice Address - Street 1:500 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-3337
Practice Address - Country:US
Practice Address - Phone:662-369-9525
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05923011Medicaid
I40300Medicare UPIN