Individual
MARK R BARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7177 MAIN ST, BONNERS FERRY, ID 83805
(208) 267-2020
(208) 267-8748
Mailing address
PO BOX U, BONNERS FERRY, ID 83805-1280
(208) 267-2020
(208) 267-8748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0-541
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001963000
—
ID
Enumeration date
06/21/2005
Last updated
03/11/2008
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