Provider Demographics
NPI:1982679072
Name:BARKER, JANE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:MARIE
Last Name:BARKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1144 LAZY HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:IL
Mailing Address - Zip Code:62269-7043
Mailing Address - Country:US
Mailing Address - Phone:618-628-2193
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY 61 AND 32
Practice Address - Street 2:
Practice Address - City:STE. GENEVIEVE
Practice Address - State:MO
Practice Address - Zip Code:63670
Practice Address - Country:US
Practice Address - Phone:573-883-7786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112187207Q00000X, 207P00000X
IL036-110429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036110429Medicaid
IL08232205OtherBLUE CROSS BLUE SHIELD
IL036110429Medicaid
IL08232205OtherBLUE CROSS BLUE SHIELD