Provider Demographics
NPI:1992743736
Name:BARKO, KEVIN J (PA)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:BARKO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 CAMPUS BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2888
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:759 S MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664-1127
Practice Address - Country:US
Practice Address - Phone:540-459-1540
Practice Address - Fax:540-459-1486
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110001968363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010198348Medicaid
P00300996OtherRAILROAD MEDICARE
VA010198348Medicaid
007793F01Medicare PIN
P00300996OtherRAILROAD MEDICARE