Provider Demographics
NPI:1104863554
Name:KYRIAKIDIS, KYRIAKOS E (MD)
Entity type:Individual
Prefix:
First Name:KYRIAKOS
Middle Name:E
Last Name:KYRIAKIDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-222-6977
Mailing Address - Fax:615-222-5322
Practice Address - Street 1:4220 HARDING PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-6977
Practice Address - Fax:615-222-5322
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35477207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4055990OtherBCBS
5461405OtherAETNA
TN6010868OtherBCBS
TN4141592OtherBLUE CROSS
3868710OtherMEDICARE
KY6412546100OtherKENTUCKY MEDICAID
P00380422OtherRAILROAD MEDICARE
TN3868712Medicaid
KY6412546100OtherKENTUCKY MEDICAID
3868710OtherMEDICARE
TN6010868OtherBCBS