Healthcare Provider Details

I. General information

NPI: 1801868815
Provider Name (Legal Business Name): FREDERICK W BARKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WESTWOOD CMN
BLUEFIELD VA
24605-2031
US

IV. Provider business mailing address

407 W SOUTH ST
UNION SC
29379-2771
US

V. Phone/Fax

Practice location:
  • Phone: 276-322-2324
  • Fax: 276-322-2325
Mailing address:
  • Phone: 864-427-6058
  • Fax: 864-427-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number15881
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101050124
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: