Provider Demographics
NPI:1619050218
Name:BARROW, GREGORY S (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:S
Last Name:BARROW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N HIGHWAY 27 UNIT G
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2431
Mailing Address - Country:US
Mailing Address - Phone:352-242-5155
Mailing Address - Fax:352-243-4187
Practice Address - Street 1:221 N HIGHWAY 27 UNIT G
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2431
Practice Address - Country:US
Practice Address - Phone:352-242-5155
Practice Address - Fax:352-243-4187
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME900552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21868037OtherTAX ID
FLE90931Medicare UPIN
48625Medicare ID - Type Unspecified