Provider Demographics
NPI:1801065651
Name:GLASER-CARPENTER, AMY J (DO)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:J
Last Name:GLASER-CARPENTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:981 STATE ROUTE 46 E STE A
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47006-7630
Mailing Address - Country:US
Mailing Address - Phone:812-558-5778
Mailing Address - Fax:812-610-8336
Practice Address - Street 1:981 STATE ROUTE 46 E STE A
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47006-7630
Practice Address - Country:US
Practice Address - Phone:812-558-5778
Practice Address - Fax:812-610-8336
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005019A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300000510Medicaid
CO29128277Medicaid
CO29128277Medicaid
CO301679Medicare PIN