Healthcare Provider Details
I. General information
NPI: 1508800657
Provider Name (Legal Business Name): MICHAEL BARKMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1255 HILYARD ST
EUGENE OR
97401-3718
US
IV. Provider business mailing address
PO BOX 4078
PORTLAND OR
97208-4078
US
V. Phone/Fax
- Phone: 503-686-7300
- Fax:
- Phone: 888-633-0086
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | MD15644 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 76161 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | WASHINGTON L&I |
| # 2 | |
| Identifier | E08113 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | LIPA |
| # 3 | |
| Identifier | J0475-01 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PACIFIC SOURCE |
| # 4 | |
| Identifier | 057221009 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BCBS |
| # 5 | |
| Identifier | E08113 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | PROVIDENCE |
| # 6 | |
| Identifier | 8279960 |
| Identifier Type | MEDICAID |
| Identifier State | WA |
| Identifier Issuer | |
| # 7 | |
| Identifier | 210559 |
| Identifier Type | MEDICAID |
| Identifier State | OR |
| Identifier Issuer | |
| # 8 | |
| Identifier | A002 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | CHAMPUS |
| # 9 | |
| Identifier | E08113 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | GROUP HEALTH |
| # 10 | |
| Identifier | XPY185025 |
| Identifier Type | MEDICAID |
| Identifier State | CA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: