Individual
MARTHA MICHELLE BARLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
(918) 458-3610
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
(918) 458-3610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3248
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08175316
RAILROAD MEDICARE
OK
05
—
100137980C
—
OK
01
—
100699880B
GROUP MEDICAID NUMBER
OK
01
—
730777479002
GROUP BLUECROSSBLUESHIELD
OK
01
—
CG9653
GROUP RAILROAD MEDICARE
OK
01
—
H37015401
GROUP MEDICARE NUMBER
OK
Enumeration date
08/16/2006
Last updated
05/23/2019
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