Healthcare Provider Details

I. General information

NPI: 1588629570
Provider Name (Legal Business Name): MATTHEW ALDERSON BARKER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 S LOUISE AVE STE 1110
SIOUX FALLS SD
57108-6030
US

IV. Provider business mailing address

6100 S LOUISE AVE STE 1110
SIOUX FALLS SD
57108-6030
US

V. Phone/Fax

Practice location:
  • Phone: 605-504-1900
  • Fax: 605-504-1901
Mailing address:
  • Phone: 605-504-1900
  • Fax: 605-504-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number46562
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number87551
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number87551
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number46562
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number7502
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: