Healthcare Provider Details

I. General information

NPI: 1801089214
Provider Name (Legal Business Name): LANCE FRED BARKER M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 S MEDICAL DR STE 200
BRIGHAM CITY UT
84302-3293
US

IV. Provider business mailing address

1041 S MEDICAL DR STE 200
BRIGHAM CITY UT
84302-3293
US

V. Phone/Fax

Practice location:
  • Phone: 435-723-5248
  • Fax: 435-723-5240
Mailing address:
  • Phone: 435-723-5248
  • Fax: 435-723-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6681723-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number6681723-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: