Provider Demographics
NPI:1154349744
Name:BARKDOLL, DANIEL JAMES (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAMES
Last Name:BARKDOLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 639353
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9263
Mailing Address - Country:US
Mailing Address - Phone:812-537-8241
Mailing Address - Fax:812-537-1041
Practice Address - Street 1:98 ELM ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2048
Practice Address - Country:US
Practice Address - Phone:812-496-8775
Practice Address - Fax:812-537-5710
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043851A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200042340BMedicaid
IN172420CMedicare PIN
IN000000074845OtherANTHEM PROVIDER #