Individual
DR. WAYNE S BARKSDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1049 N PINE RD, OLLA, LA 71465-4826
(318) 495-3175
(318) 495-0750
Mailing address
1102 N PINE RD, OLLA, LA 71465-4804
(313) 495-5308
(318) 495-0750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
021079
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021079
LICENSE #
LA
01
—
080132328
RR MCR
—
05
—
195096
—
LA
01
—
4547495
AETNA
—
01
—
9213426005
CIGNA
—
Enumeration date
06/20/2005
Last updated
05/10/2019
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