Individual
DR. BRIAN JACOBS SHIOZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH, MHA, FACOEM
Contact information
Practice address
200 BRULE ST BLDG 871, FORT KNOX, KY 40121-6100
(502) 626-9743
Mailing address
200 BRULE ST BLDG 871, FORT KNOX, KY 40121-6100
(502) 626-9743
Taxonomy
Speciality
Code
Description
License number
State
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
P9732
TX
2083X0100X
Occupational Medicine Physician
Primary
P9732
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22-173750
MEDICAL REVIEW OFFICER
—
01
—
88680083540
MEDICAL EXAMINER
—
Enumeration date
06/06/2012
Last updated
11/08/2023
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