Provider Demographics
NPI:1962562223
Name:BARKLEY, NANCY-JO (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY-JO
Middle Name:
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:BARKLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:208 BULLDOG BLVD
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-1073
Mailing Address - Country:US
Mailing Address - Phone:918-396-1969
Mailing Address - Fax:
Practice Address - Street 1:208 BULLDOG BLVD
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-1073
Practice Address - Country:US
Practice Address - Phone:918-396-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3198111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU-75995Medicare UPIN