Provider Demographics
NPI:1083666101
Name:BARROWS, KIMBERLY A (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:BARROWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4597 QUAIL RIDGE CT NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8508
Mailing Address - Country:US
Mailing Address - Phone:478-213-7740
Mailing Address - Fax:
Practice Address - Street 1:1471 E BELTLINE AVE NE STE 201
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-4548
Practice Address - Country:US
Practice Address - Phone:616-685-8620
Practice Address - Fax:616-447-7674
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051207207Q00000X
NE26361207Q00000X
CO47259207Q00000X
MI4301104391207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA533244426BMedicaid
I50123Medicare UPIN
GA08CBBJGMedicare ID - Type Unspecified