Provider Demographics
NPI:1770810848
Name:GLEINER, J ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:J ARTHUR
Middle Name:
Last Name:GLEINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1153
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-1153
Mailing Address - Country:US
Mailing Address - Phone:802-249-1279
Mailing Address - Fax:
Practice Address - Street 1:1878 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4776
Practice Address - Country:US
Practice Address - Phone:802-253-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0009223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1017175Medicaid
001435701Medicare PIN