Provider Demographics
NPI:1235139247
Name:BARROW, DARLA SHERROD (OD)
Entity Type:Individual
Prefix:DR
First Name:DARLA
Middle Name:SHERROD
Last Name:BARROW
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1498
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42276-3498
Mailing Address - Country:US
Mailing Address - Phone:270-725-8382
Mailing Address - Fax:270-725-9666
Practice Address - Street 1:709 EAST 4TH STREET
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
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2007-07-09
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
KY1405DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY77014058Medicaid
KY77903755Medicaid
KY77014058Medicaid
KY9359401Medicare ID - Type Unspecified