Healthcare Provider Details

I. General information

NPI: 1982080255
Provider Name (Legal Business Name): DAWN BARKER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 S KANSAS EXPY STE B
SPRINGFIELD MO
65807-6989
US

IV. Provider business mailing address

PO BOX 505673
SAINT LOUIS MO
63150-5673
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-0269
  • Fax: 417-269-0279
Mailing address:
  • Phone: 417-730-6430
  • Fax: 417-269-7567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2018008535
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: