Individual
DR. JEFFREY D GLAZER
Active
Individual
DR. JEFFREY D GLAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
25111
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64251119
—
KY
01
—
K205680
MEDICARE PTAN-AMERICANA
KY
01
—
K205681
MEDICARE PTAN - PORTLAND
KY
01
—
K205682
MEDICARE PTAN- EAST BROADWAY
KY
01
—
K205683
MEDICARE PTAN - IROQUOIS
KY
01
—
K205684
MEDICARE PTAN - PHOENIX
KY
01
—
K205685
MEDICARE PTAN - SOUTHWEST
KY
01
—
K205686
MEDICARE PTAN- FAIRDALE
KY
Enumeration date
04/08/2006
Last updated
04/14/2021
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