Provider Demographics
NPI:1922104140
Name:BARLOW, DOUGLAS HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:HOWARD
Last Name:BARLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10001 S EASTERN AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3907
Mailing Address - Country:US
Mailing Address - Phone:702-566-2400
Mailing Address - Fax:702-433-2477
Practice Address - Street 1:10001 S EASTERN AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3907
Practice Address - Country:US
Practice Address - Phone:702-566-2400
Practice Address - Fax:702-433-2477
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0062655208000000X
NV16180208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007940300Medicaid
FL006121900Medicaid
FL006121900Medicaid