Provider Demographics
NPI:1861441438
Name:SHIRAR, GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:SHIRAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1057 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2644
Mailing Address - Country:US
Mailing Address - Phone:859-254-5001
Mailing Address - Fax:859-255-3248
Practice Address - Street 1:1057 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2644
Practice Address - Country:US
Practice Address - Phone:859-254-5001
Practice Address - Fax:859-255-3248
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor