Basic Information
Provider Information
NPI: 1659725075
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARKER
FirstName: JOSEPH
MiddleName: GREGORY
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 60447
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282600447
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 114 CHARLOIS BLVD
Address2:  
City: WINSTON SALEM
State: NC
PostalCode: 271031522
CountryCode: US
TelephoneNumber: 3367655470
FaxNumber: 3364995428
Other Information
ProviderEnumerationDate: 04/21/2016
LastUpdateDate: 10/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X2020-02541NCY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


Home