Provider Demographics
NPI:1679528210
Name:BARROW, DOUGLAS R (CRNA)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:BARROW
Suffix:
Gender:M
Credentials:CRNA
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 220
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0220
Mailing Address - Country:US
Mailing Address - Phone:423-899-9080
Mailing Address - Fax:
Practice Address - Street 1:105 N MEADOWS DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-4172
Practice Address - Country:US
Practice Address - Phone:423-899-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN9360367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3621408Medicaid
TN4103258OtherBLUE CROSS BLUE SHIELD
TNP00217452OtherRAILROAD MEDICARE
TN3621408Medicaid