Individual
KEITH DAVID BARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
621 E LLANO ESTACADO BLVD, CLOVIS, NM 88101-0609
(575) 769-2339
(575) 769-0672
Mailing address
PO BOX 609, 621 E LLANO ESTACADO BLVD, CLOVIS, NM 88102-0609
(575) 769-2339
(575) 769-0672
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2239
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000P1217
—
NM
01
—
410020718
RAILROAD
NM
01
—
5057692339
VSP
NM
Enumeration date
09/20/2005
Last updated
04/16/2013
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