Provider Demographics
NPI:1033120662
Name:DARLA SHERROD BARROW
Entity Type:Organization
Organization Name:DARLA SHERROD BARROW
Other - Org Name:BARROW EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:T
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-725-8382
Mailing Address - Street 1:PO BOX 1498
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276
Mailing Address - Country:US
Mailing Address - Phone:270-725-8382
Mailing Address - Fax:270-725-9666
Practice Address - Street 1:709 EAST 4TH ST
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:KY
Practice Address - Zip Code:42276
Practice Address - Country:US
Practice Address - Phone:270-725-8382
Practice Address - Fax:270-725-9666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0007243418OtherAETNA
KY77903755Medicaid
KY0005609695OtherAETNA
KY77001113Medicaid
KY77014058Medicaid
KY000000261068OtherBCBS
KY000000051994OtherBCBS
KY000000261068OtherBCBS
KY0005609695OtherAETNA
KY000000051994OtherBCBS
KY1256800001Medicare ID - Type Unspecified
KY77903755Medicaid