1043244510 NPI number — CHRISTINA L BARLOW M.D.

Table of content: CHRISTINA L BARLOW M.D. (NPI 1043244510)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043244510 NPI number — CHRISTINA L BARLOW M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARLOW
Provider First Name:
CHRISTINA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043244510
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
965 RIDGE LAKE BLVD STE 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38120-9446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-227-3255
Provider Business Mailing Address Fax Number:
901-227-3205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 N STATE ST
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39202-2000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-352-2273
Provider Business Practice Location Address Fax Number:
601-714-3215
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  14955 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00119633 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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