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NPI Code Detail

MEDICARE: DR. KEVIN BRADLEY BARKER M.D.

MEDICARE: DR. KEVIN BRADLEY BARKER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianMD.025422LA
2207RG0100XGastroenterology Physician20233MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19825188OTHERMSAETNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992790463
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN BRADLEY BARKER M.D.
Provider Business Mailing Address
First Line : 415 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39401-7246
Country : US
Telephone Number : 601-268-5680
Fax Number : 601-579-5240
Provider Business Practice Location Address
First Line : 415 S 28TH AVE
Second Line :
City : HATTIESBURG
State : MS
Zip : 39401-7246
Country : US
Telephone Number : 601-268-5680
Fax Number : 601-268-5778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 07/22/2020

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