Healthcare Provider Details

I. General information

NPI: 1881000545
Provider Name (Legal Business Name): ARNOLD G. SHAPIRO MD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 DIXIE HWY SUITE 200
FT WRIGHT KY
41011-2766
US

IV. Provider business mailing address

1717 DIXIE HWY SUITE 200
FT WRIGHT KY
41011-2766
US

V. Phone/Fax

Practice location:
  • Phone: 859-341-7453
  • Fax: 859-344-3183
Mailing address:
  • Phone: 859-341-7453
  • Fax: 859-344-3183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22192
License Number StateKY

VIII. Authorized Official

Name: DR. ARNOLD G. SHAPIRO
Title or Position: OWNER
Credential: M.D.
Phone: 859-341-7453