Provider Demographics
NPI:1770771461
Name:BARKER FAMILY VISION CARE LLC
Entity type:Organization
Organization Name:BARKER FAMILY VISION CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:417-587-0221
Mailing Address - Street 1:241 BOS CIR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:MO
Mailing Address - Zip Code:65754-9100
Mailing Address - Country:US
Mailing Address - Phone:417-587-0221
Mailing Address - Fax:
Practice Address - Street 1:18401 STATE HIGHWAY 13
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737-9609
Practice Address - Country:US
Practice Address - Phone:417-272-0169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO3261152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty