Provider Demographics
NPI:1801021811
Name:GRAY W. BARROW, M.D., LTD.
Entity Type:Organization
Organization Name:GRAY W. BARROW, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:GRAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-768-8572
Mailing Address - Street 1:PO BOX 84358
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-4358
Mailing Address - Country:US
Mailing Address - Phone:225-768-8572
Mailing Address - Fax:225-768-8581
Practice Address - Street 1:4545 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-5602
Practice Address - Country:US
Practice Address - Phone:225-768-8572
Practice Address - Fax:225-768-8581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA020442225500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1934399Medicaid
LAF32733Medicare UPIN
LA5R074Medicare PIN
LA250004018Medicare PIN