Healthcare Provider Details

I. General information

NPI: 1912059007
Provider Name (Legal Business Name): THOMAS K BARLOW D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1593 N REDWOOD RD STE 2
SARATOGA SPRINGS UT
84045-3919
US

IV. Provider business mailing address

1593 N REDWOOD RD STE 2
SARATOGA SPRINGS UT
84045-3919
US

V. Phone/Fax

Practice location:
  • Phone: 801-834-3354
  • Fax:
Mailing address:
  • Phone: 619-940-0021
  • Fax: 801-872-5264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number20A16423
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberDO2650
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: