Organization
WENDELL STREET PSYCHIATRIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIKKI KING BARKER DO (OWNER PRESIDENT)
(907) 455-4135
Entity
Organization
Contact information
Practice address
225 WENDELL ST, STE B, FAIRBANKS, AK 99701-4835
(907) 455-4135
(907) 455-4115
Mailing address
225 WENDELL ST, STE B, FAIRBANKS, AK 99701-4835
(907) 455-4135
(907) 455-4115
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
3921
AK
2084P0804X
Child & Adolescent Psychiatry Physician
3921
AK
2084P0805X
Geriatric Psychiatry Physician
3921
AK
Other
Enumeration date
05/22/2007
Last updated
08/08/2007
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