Individual
DR. JEFFREY D GLAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(812) 218-8926
(812) 218-8930
Mailing address
PO BOX 950244, LOUISVILLE, KY 40295-0244
(502) 953-4700
(502) 772-8189
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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