Basic Information
| Provider Information | |||||||||
| NPI: | 1477546133 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARKSDALE | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1914 SANDPIPER AVE | ||||||||
| Address2: | |||||||||
| City: | LOWELL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727458667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4792509114 | ||||||||
| FaxNumber: | 8447931334 | ||||||||
| Practice Location | |||||||||
| Address1: | 2709 SE OTIS CORLEY DR STE 19 | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727123410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4792509114 | ||||||||
| FaxNumber: | 8447931334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2005 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/19/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 08893 | AR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.