Provider Demographics
NPI:1215043047
Name:KOURY, HAMEED I (MD)
Entity Type:Individual
Prefix:
First Name:HAMEED
Middle Name:I
Last Name:KOURY
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 1:1110 LANCASTER RD STE 3
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8792
Mailing Address - Country:US
Mailing Address - Phone:859-623-3576
Mailing Address - Fax:859-624-9682
Practice Address - Street 1:1110 LANCASTER RD STE 3
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8792
Practice Address - Country:US
Practice Address - Phone:859-623-3576
Practice Address - Fax:859-624-9682
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26402208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY021113600OtherUS DEPARTMENT OF LABOR
KY1462989OtherUMWA
KY1276OtherCHA
KY163843500OtherUS DEPARTMENT OF LABOR
KY1700283OtherUNITED HEALTHCARE
KYK011100OtherPGBA, LLC
KY1344695OtherCIGNA
KY1463071OtherUMWA
KY000000050186OtherANTHEM
KY020016801OtherTRAVELERS MEDICARE
KY64264021Medicaid
KY0004329906OtherAETNA
KY5000560OtherPASSPORT HEALTH
KY0004329906OtherAETNA
KY1462989OtherUMWA
KY0264301Medicare PIN