Provider Demographics
NPI:1508252230
Name:BARROW, JENNIFER FLENNIKEN (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FLENNIKEN
Last Name:BARROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:FLENNIKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5613 MONARCH WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-0997
Mailing Address - Country:US
Mailing Address - Phone:318-455-5779
Mailing Address - Fax:337-421-0015
Practice Address - Street 1:1960 TYBEE LN
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-4173
Practice Address - Country:US
Practice Address - Phone:337-421-0090
Practice Address - Fax:337-421-0015
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA306578207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine