Healthcare Provider Details

I. General information

NPI: 1003800921
Provider Name (Legal Business Name): GILBERT D. SHAPIRO DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GILBERT D SHAPIRO DPM, PC

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1888 N COUNTRY CLUB RD
TUCSON AZ
85716-3115
US

IV. Provider business mailing address

1888 N COUNTRY CLUB RD
TUCSON AZ
85716-3115
US

V. Phone/Fax

Practice location:
  • Phone: 520-327-6367
  • Fax: 520-318-4492
Mailing address:
  • Phone: 520-327-6367
  • Fax: 520-318-4492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number0173
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: