1194942581 NPI number — TIMOTHY S. BARLOW, DDS, PA

Table of content: (NPI 1194942581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194942581 NPI number — TIMOTHY S. BARLOW, DDS, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMOTHY S. BARLOW, DDS, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1194942581
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
515 KEISLER DR
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
CARY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27511-7097
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-859-5459
Provider Business Mailing Address Fax Number:
919-859-9818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
515 KEISLER DR
Provider Second Line Business Practice Location Address:
SUITE 204
Provider Business Practice Location Address City Name:
CARY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27511-7097
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-859-5459
Provider Business Practice Location Address Fax Number:
919-859-9818
Provider Enumeration Date:
04/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BARLOW
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
919-859-5459

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  6314 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7990410 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90410 . This is a "BCBS (FEP)" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 9124 . This is a "DELTA DENTAL OF NJ" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 626115 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 4083214 . This is a "BCBS OF TN" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 283557 . This is a "BCBS OF MA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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