Provider Demographics
NPI:1831311166
Name:LOU R. BARKER M.D., P.C.
Entity Type:Organization
Organization Name:LOU R. BARKER M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCRETIA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-374-7801
Mailing Address - Street 1:1112 PLAZA AVENUE STE. B
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023
Mailing Address - Country:US
Mailing Address - Phone:478-374-7801
Mailing Address - Fax:478-374-7878
Practice Address - Street 1:1112 PLAZA AVE
Practice Address - Street 2:STE B
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-9009
Practice Address - Country:US
Practice Address - Phone:478-374-7801
Practice Address - Fax:478-374-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00791238AMedicaid
GA16BBCFWMedicare PIN
GA00791238AMedicaid