Barker, Keith David
Barker, Keith David is an sole proprietor health care provider with primary practice located at 621 E Llano Estacado Blvd , Clovis NM 88101-0609. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Barker, Keith David can be contacted via phone (575) 769-2339.Contact Information
Primary practice address
621 E Llano Estacado Blvd
Clovis NM 88101-0609
Phone: (575) 769-2339
Fax: (575) 769-0672
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2239 | New Mexico |
Profile Details
| NPI number | 1215923867 |
|---|---|
| LBN Legal business name | Barker, Keith David |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Apr 16th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215923867 | NPPES |
| New Mexico | MEDICAID | 0000P1217 | |
| New Mexico | Other | 410020718 | |
| New Mexico | Other | 5057692339 |
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