Provider Demographics
NPI:1265434492
Name:BARKLEY, RICHARD LOGAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LOGAN
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 1:1000 JACKSON RD
Mailing Address - Street 2:STE 200
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3176
Mailing Address - Country:US
Mailing Address - Phone:615-851-7102
Mailing Address - Fax:
Practice Address - Street 1:1000 JACKSON RD
Practice Address - Street 2:STE 200
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3176
Practice Address - Country:US
Practice Address - Phone:615-851-7102
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS 29871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice