Provider Demographics
NPI:1528037454
Name:BARROWS, KELLY (OD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:BARROWS
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 1:3911 BYRNWYCK PL NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1661
Mailing Address - Country:US
Mailing Address - Phone:404-518-8322
Mailing Address - Fax:
Practice Address - Street 1:5200 WINDWARD PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3842
Practice Address - Country:US
Practice Address - Phone:770-777-6872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA-1251-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA667833125BMedicaid
GAP00234623OtherRAILROAD MEDICARE
GA667833125CMedicaid
GA41ZCFSSMedicare Oscar/Certification
GA667833125BMedicaid