Healthcare Provider Details

I. General information

NPI: 1649408998
Provider Name (Legal Business Name): DEREK ALAN BARKER D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 N RIVER ST
CLAXTON GA
30417-5920
US

IV. Provider business mailing address

4425 PAULSEN ST
SAVANNAH GA
31405-3662
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-6615
  • Fax: 855-645-0468
Mailing address:
  • Phone: 912-355-6615
  • Fax: 855-645-0468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901002322
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPOD001472
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: