Provider Demographics
NPI:1891802625
Name:BARKLEY, TY HARRISON (DDS)
Entity Type:Individual
Prefix:DR
First Name:TY
Middle Name:HARRISON
Last Name:BARKLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 EXETER RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3945
Mailing Address - Country:US
Mailing Address - Phone:901-755-4132
Mailing Address - Fax:901-755-7283
Practice Address - Street 1:2008 EXETER RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3945
Practice Address - Country:US
Practice Address - Phone:901-755-4132
Practice Address - Fax:901-755-7283
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN80091223G0001X
AR34021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice