Individual
STEPHEN WAYNE BARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
830 SOUTH GLOSTER, TUPELO, MS 38801
(662) 377-4394
(662) 377-7045
Mailing address
3637 LYLES DR, OXFORD, MS 38655-5708
(662) 234-4883
(662) 377-7094
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R549797
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00121162
—
MS
01
—
009936742
MEDICAID
AL
Enumeration date
07/17/2006
Last updated
07/29/2010
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