=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174644538
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAWN MICHELLE BARLOW MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2007
-----------------------------------------------------
Last Update Date | 03/02/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 W MAIN ST
-----------------------------------------------------
City | LIVINGSTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38570-1718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-823-5681
-----------------------------------------------------
Fax | 931-403-2615
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 67
-----------------------------------------------------
City | LIVINGSTON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 38570-0067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-403-1197
-----------------------------------------------------
Fax | 931-403-2615
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 45921
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------