Provider Demographics
NPI:1528311859
Name:MARK V. BARROW, SR, MD, PA
Entity type:Organization
Organization Name:MARK V. BARROW, SR, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:V
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-336-8100
Mailing Address - Street 1:1731 NW 6TH ST
Mailing Address - Street 2:STE. B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-8554
Mailing Address - Country:US
Mailing Address - Phone:352-336-8100
Mailing Address - Fax:352-336-8100
Practice Address - Street 1:1731 NW 6TH ST
Practice Address - Street 2:STE. B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-8554
Practice Address - Country:US
Practice Address - Phone:352-336-8100
Practice Address - Fax:352-336-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME9103207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLO1799Medicare PIN
FLD50210Medicare UPIN