Provider Demographics
NPI:1568508158
Name:SHAPIRO, ARNOLD GLAZER (MD)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:GLAZER
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1717 DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011
Mailing Address - Country:US
Mailing Address - Phone:859-341-7453
Mailing Address - Fax:859-344-3183
Practice Address - Street 1:1717 DIXIE HIGHWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011
Practice Address - Country:US
Practice Address - Phone:859-341-7453
Practice Address - Fax:859-344-3183
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY221922084P0800X
OH2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64221922Medicaid
1350401Medicare ID - Type Unspecified