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General NPI Number Information
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NPI Number | 1326361668
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Entity Type | Individual
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Provider Name | LISA A BARACKER DO
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Gender | Female
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 2809 NE LINCOLN RD
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City | IDABEL
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State | OK
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Zip | 74745-2421
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Country | US
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Telephone | 580-286-6688
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Fax | 580-286-6699
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Provider Business Mailing Address
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Address Line | 2809 NE LINCOLN RD
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City | IDABEL
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State | OK
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Zip | 74745-2421
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Country | US
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Telephone | 580-286-6688
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Fax | 580-286-6699
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO220145
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5180
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License Number State | OK
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