Basic Information
| Provider Information | |||||||||
| NPI: | 1629268263 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARKER | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BRUNER | ||||||||
| OtherFirstName: | KAREN | ||||||||
| OtherMiddleName: | E | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 7987 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Practice Location | |||||||||
| Address1: | 8725 COUNTY ROAD 64 | ||||||||
| Address2: | |||||||||
| City: | DAPHNE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516251370 | ||||||||
| FaxNumber: | 2516251380 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2007 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207K00000X | 0101245570 | VA | N | Allopathic & Osteopathic Physicians | Allergy & Immunology | 208000000X | 35873 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | 207K00000X | 35873 | AL | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
ID Information
| ID | Type | State | Issuer | Description | 512-05647 | 01 | AL | BCBS | OTHER | P01907802 | 01 | AL | RR MEDICARE | OTHER | 511-93270 | 01 | AL | BCBS | OTHER | 512-05646 | 01 | AL | BCBS | OTHER | 102I031848 | 01 | AL | MEDICARE | OTHER | 4960941 | 01 | AL | AETNA | OTHER | 5569791 | 01 | AL | CIGNA HC | OTHER | 201687 | 05 | AL | MEDICAID | 202480 | 05 | AL | MEDICAID | 212046 | 05 | AL | MEDICAID | Z98674 | 01 | AL | VIVA HEALTH | OTHER | 203708 | 05 | AL | MEDICAID | 212073 | 05 | AL | MEDICAID | 6431576 | 01 | AL | UHC | OTHER | 6982839 | 01 | MS | MS MEDICAID | OTHER |