Healthcare Provider Details

I. General information

NPI: 1528053527
Provider Name (Legal Business Name): RICHARD D BARKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 W WOOSTER ST BOWLING GREEN ORTHOPAEDICS SUITE #222
BOWLING GREEN OH
43402-2643
US

IV. Provider business mailing address

970 W WOOSTER ST
BOWLING GREEN OH
43402-2643
US

V. Phone/Fax

Practice location:
  • Phone: 419-352-1519
  • Fax: 419-352-7004
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35037974
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35037974
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number35037974
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number35037974
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: