Provider Demographics
NPI:1174576003
Name:BARLOW, KELLY KAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:KAY
Last Name:BARLOW
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 PARKRIDGE DR
Mailing Address - Street 2:PO BOX 6877
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-7477
Mailing Address - Country:US
Mailing Address - Phone:479-474-7171
Mailing Address - Fax:479-474-3131
Practice Address - Street 1:1515 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-2246
Practice Address - Country:US
Practice Address - Phone:479-474-7171
Practice Address - Fax:479-474-3131
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR8452183500000X
AR8452183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR8452OtherSTATE LICENSE NUMBER