Provider Demographics
NPI:1831152347
Name:BARKLEY, KARL L II (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:L
Last Name:BARKLEY
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-510-8000
Mailing Address - Fax:704-510-8006
Practice Address - Street 1:10810 MALLARD CREEK ROAD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-9771
Practice Address - Country:US
Practice Address - Phone:704-510-8000
Practice Address - Fax:704-510-8006
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33471207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913391Medicaid
NC8913391Medicaid
NCE94980Medicare UPIN
NC2163343GMedicare PIN