Provider Demographics
NPI:1336355023
Name:BARKER, BRENDA GAY (MD)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:GAY
Last Name:BARKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 BRAEWICK ROAD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226
Mailing Address - Country:US
Mailing Address - Phone:317-445-5883
Mailing Address - Fax:317-547-9949
Practice Address - Street 1:11 N EASTERN AVENUE
Practice Address - Street 2:GOOD SAMARITAN HEALTH CLINIC
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201
Practice Address - Country:US
Practice Address - Phone:317-638-2862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032751B207Q00000X
IN01032751A2083A0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine