Provider Demographics
NPI:1861583833
Name:BARROW, MARK VELPEAU SR (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:VELPEAU
Last Name:BARROW
Suffix:SR
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731-B NW 6TH STEET
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3531
Mailing Address - Country:US
Mailing Address - Phone:352-373-5616
Mailing Address - Fax:352-375-3413
Practice Address - Street 1:1731-B NW 6TH STEET
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3531
Practice Address - Country:US
Practice Address - Phone:352-373-5616
Practice Address - Fax:352-375-3413
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME9103207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL051099800Medicaid
01799Medicare ID - Type Unspecified
FL051099800Medicaid