1427004332 NPI number — JOHN R BARROWCLOUGH MD

Table of content: JOHN R BARROWCLOUGH MD (NPI 1427004332)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427004332 NPI number — JOHN R BARROWCLOUGH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BARROWCLOUGH
Provider First Name:
JOHN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1427004332
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 636019
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45263-6019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
865-985-7234
Provider Business Mailing Address Fax Number:
865-985-7077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 GREENWAY CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERWIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37650-2177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-743-3141
Provider Business Practice Location Address Fax Number:
865-985-7077
Provider Enumeration Date:
05/25/2006

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: 207P00000X , with the licence number:  016843 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3020835 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00255411 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 7100148130 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0175653 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".




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