Provider Demographics
NPI:1023283876
Name:BARKER, DEAN L (RPH)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:L
Last Name:BARKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SOMERS RD
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:MI
Mailing Address - Zip Code:48851-9790
Mailing Address - Country:US
Mailing Address - Phone:616-527-9578
Mailing Address - Fax:
Practice Address - Street 1:10767 E. CARSON CITY ROAD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:MI
Practice Address - Zip Code:48811
Practice Address - Country:US
Practice Address - Phone:989-584-3077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist