Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN11423 | FL |
NPI | 1023013281 |
---|---|
Provider Name | Dr. Wayne S. Barker |
First Address | Jacksonville, FL 32256-9180 |
Second Address | Jacksonville, FL 32256-9180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 08/07/2007 |