Provider Demographics
NPI:1235247990
Name:AHMED, AYAZ (MD)
Entity Type:Individual
Prefix:MR
First Name:AYAZ
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1321 RING RD
Mailing Address - Street 2:STE 105
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-8940
Mailing Address - Country:US
Mailing Address - Phone:270-986-7373
Mailing Address - Fax:270-900-1131
Practice Address - Street 1:1321 RING RD
Practice Address - Street 2:STE 107
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-8940
Practice Address - Country:US
Practice Address - Phone:270-986-7392
Practice Address - Fax:270-900-1131
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY32313207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1055558OtherPASSPORT ET PROV #
KY1055560OtherPASSPORT HV PROV #
KY5732240OtherAETNA PROV #
KY940008659OtherPHCS PROV #
KY000000042799OtherANTHEM HV PROV #
KY1342353OtherMAILHANDLERS RC PROV #
KY000000041592OtherANTHEM ET PROV #
KY110152113OtherUNITED HEALTHCARE PROV #
KY1354161OtherMAILHANDLERS ET PROV #
KY64323132Medicaid
KY1055561OtherPASSPORT RC PROV #
KY110185034OtherUNITED HEALTHCARE PROV #
KY5496002OtherCIGNA PROV #
KY000000041591OtherANTHEM RC PROV #
KY110185034OtherUNITED HEALTHCARE PROV #
KY64323132Medicaid
KY1055560OtherPASSPORT HV PROV #
KY110185034OtherUNITED HEALTHCARE PROV #