Provider Demographics
NPI:1881000545
Name:ARNOLD G. SHAPIRO MD, PLLC
Entity Type:Organization
Organization Name:ARNOLD G. SHAPIRO MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:G
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-341-7453
Mailing Address - Street 1:1717 DIXIE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2766
Mailing Address - Country:US
Mailing Address - Phone:859-341-7453
Mailing Address - Fax:859-344-3183
Practice Address - Street 1:1717 DIXIE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2766
Practice Address - Country:US
Practice Address - Phone:859-341-7453
Practice Address - Fax:859-344-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY221922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64221922Medicaid
KY64221922Medicaid