Provider Demographics
NPI:1730358573
Name:STEWART E. BARLOW MD PC
Entity type:Organization
Organization Name:STEWART E. BARLOW MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-621-0350
Mailing Address - Street 1:3955 HARRISON BLVD
Mailing Address - Street 2:STE U6
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-2313
Mailing Address - Country:US
Mailing Address - Phone:801-621-0350
Mailing Address - Fax:801-621-0357
Practice Address - Street 1:3955 HARRISON BLVD
Practice Address - Street 2:STE U6
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-2313
Practice Address - Country:US
Practice Address - Phone:801-621-0350
Practice Address - Fax:801-621-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2682641205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT529809474011Medicaid
UTD07629Medicare UPIN