Provider Demographics
NPI:1326607078
Name:BARLOW, LISA M (PHARM D)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:BARLOW
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2845
Mailing Address - Country:US
Mailing Address - Phone:918-786-1092
Mailing Address - Fax:918-786-4642
Practice Address - Street 1:901 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-2845
Practice Address - Country:US
Practice Address - Phone:918-786-1092
Practice Address - Fax:918-786-4642
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13199183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist