Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 55666 | CA |
N | 1223E0200X | Endodontist | DS037341 | PA |
NPI | 1154598175 |
---|---|
Provider Name | Dr. Brian Thomas Barker |
First Address | Ventura, CA 93003-6507 |
Second Address | Ventura, CA 93003-6507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 31/03/2014 |