Provider Demographics
NPI:1740941517
Name:BARKER, MARY PAIGE (MPT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:PAIGE
Last Name:BARKER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 BURBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROGUE RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97537-4524
Mailing Address - Country:US
Mailing Address - Phone:541-951-2333
Mailing Address - Fax:
Practice Address - Street 1:400 EARHART ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-7828
Practice Address - Country:US
Practice Address - Phone:541-816-4747
Practice Address - Fax:541-787-4011
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5181208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation