Provider Demographics
NPI:1134154495
Name:BARLOW, DARRYK W (MD)
Entity type:Individual
Prefix:DR
First Name:DARRYK
Middle Name:W
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 1:10202 E BURNSIDE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-2732
Mailing Address - Country:US
Mailing Address - Phone:503-257-3204
Mailing Address - Fax:503-255-7208
Practice Address - Street 1:10202 E BURNSIDE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-2732
Practice Address - Country:US
Practice Address - Phone:503-257-3204
Practice Address - Fax:503-255-7208
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24476207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR226920Medicaid
OR226920Medicaid
OR115472Medicare ID - Type Unspecified