Provider Demographics
NPI:1265893523
Name:BARKER, JOHN SR
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BARKER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2864 PEASE DR
Mailing Address - Street 2:APT 203
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3241
Mailing Address - Country:US
Mailing Address - Phone:440-503-4377
Mailing Address - Fax:
Practice Address - Street 1:2112 CASE PKWY STE 10
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-2378
Practice Address - Country:US
Practice Address - Phone:330-425-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN093509164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse