Provider Demographics
NPI:1669456851
Name:BARLOW, JEREMY CLARK (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:CLARK
Last Name:BARLOW
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:PO BOX 530604
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35253-0604
Mailing Address - Country:US
Mailing Address - Phone:205-879-8294
Mailing Address - Fax:205-879-8259
Practice Address - Street 1:2700 10TH AVE S STE 444
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1250
Practice Address - Country:US
Practice Address - Phone:205-723-0088
Practice Address - Fax:888-748-4157
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19621207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
051009020OtherBLUE CROSS BLUE SHIELD
43022OtherHEALTHSPRING OF ALABAMA
CB0222OtherTRAVELERS MEDICARE (GROUP
43022OtherHEALTH STRATEGIES INC
631003288OtherCHAMPUS VA (GROUP)
7430423-001OtherCIGNA EMPLOYER BENEFIT
H01154OtherVIVA HEALTH
AL09029Medicaid
43022OtherMERIT HEALTH PLAN OF AL
631003288OtherTRICARE (GROUP)
2010968OtherUNITED HEALTHCARE NETWO
060069749OtherTRAVELERS MEDICARE (IND)
AL051509020Medicare ID - Type Unspecified
AL09029Medicaid