Healthcare Provider Details

I. General information

NPI: 1861587768
Provider Name (Legal Business Name): ELISABETH BARKEY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 ST MICHAELS DRIVE STE A201
SANTA FE NM
87505
US

IV. Provider business mailing address

435 ST MICHAELS DRIVE STE A201
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-9282
  • Fax: 505-988-1106
Mailing address:
  • Phone: 505-982-9282
  • Fax: 505-988-1106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number896
License Number StateNM

VIII. Authorized Official

Name: ELISABETH MAGDALENE BARKEY
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 505-982-9282