Healthcare Provider Details

I. General information

NPI: 1770414971
Provider Name (Legal Business Name): DAVID JONATHAN BARKSDALE JR. DNAP, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PERRYRIDGE RD
GREENWICH CT
06830-4608
US

IV. Provider business mailing address

2437 BEDFORD ST UNIT C2
STAMFORD CT
06905-3914
US

V. Phone/Fax

Practice location:
  • Phone: 203-661-5330
  • Fax:
Mailing address:
  • Phone: 401-864-6913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number211957
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: