Basic Information
| Provider Information | |||||||||
| NPI: | 1699952390 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WALTER BARKEY MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2256 W HILL RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485074655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102497546 | ||||||||
| FaxNumber: | 8102443376 | ||||||||
| Practice Location | |||||||||
| Address1: | 2256 W HILL RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485074655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102497546 | ||||||||
| FaxNumber: | 8102443376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2008 | ||||||||
| LastUpdateDate: | 03/22/2017 | ||||||||
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| AuthorizedOfficialLastName: | BARKEY | ||||||||
| AuthorizedOfficialFirstName: | WALTER | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8107338041 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207NP0225X | 4301045627 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology | Pediatric Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 0702513831 | 01 | MI | BCBSMI | OTHER |