Provider Demographics
NPI:1780814632
Name:BARCELOW, DEAN A (OD)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:A
Last Name:BARCELOW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 VERMONT ROUTE 107
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:VT
Mailing Address - Zip Code:05032-4456
Mailing Address - Country:US
Mailing Address - Phone:802-558-3604
Mailing Address - Fax:
Practice Address - Street 1:1593 VERMONT ROUTE 107
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:VT
Practice Address - Zip Code:05032-4456
Practice Address - Country:US
Practice Address - Phone:802-234-9728
Practice Address - Fax:802-234-9732
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0300054454152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1016712Medicaid
VT001501401Medicare PIN