Provider Demographics
NPI:1699728493
Name:ALCHUREIQI, EIYAD (MD)
Entity type:Individual
Prefix:
First Name:EIYAD
Middle Name:
Last Name:ALCHUREIQI
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 1:3085 LAKECREST CIR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1707
Mailing Address - Country:US
Mailing Address - Phone:859-258-8600
Mailing Address - Fax:859-258-8610
Practice Address - Street 1:3085 LAKECREST CIR
Practice Address - Street 2:SUITE 700
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1707
Practice Address - Country:US
Practice Address - Phone:859-258-8600
Practice Address - Fax:859-258-8610
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36636207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64049307Medicaid
KY0290712Medicare ID - Type Unspecified
H62502Medicare UPIN