Healthcare Provider Details

I. General information

NPI: 1932281623
Provider Name (Legal Business Name): WILLIAM R BARKMAN DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 LLANO STREET
AZTEC NM
87410-2172
US

IV. Provider business mailing address

102 LLANO STREET
AZTEC NM
87410-2172
US

V. Phone/Fax

Practice location:
  • Phone: 505-334-9441
  • Fax: 505-334-8750
Mailing address:
  • Phone: 505-334-9441
  • Fax: 505-334-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA130105
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA71780
License Number StateNM

VIII. Authorized Official

Name: DR. WILLIAM R BARKMAN
Title or Position: PRESIDENT
Credential: DO
Phone: 505-334-9441