Provider Demographics
NPI:1841372539
Name:BARKMAN, WILLIAM R (DO)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:BARKMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:R
Other - Last Name:BARKMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 6210
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-6210
Mailing Address - Country:US
Mailing Address - Phone:505-609-2258
Mailing Address - Fax:505-609-2259
Practice Address - Street 1:102 LLANO STREET
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-2172
Practice Address - Country:US
Practice Address - Phone:505-334-9441
Practice Address - Fax:505-334-8750
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA71780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00B23OtherBCBS
1009838OtherLOVELACE
NM26754703Medicaid
94683OtherPHP
94683OtherPHP