Provider Demographics
NPI:1467480475
Name:EICHHORN, GERALD R (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:R
Last Name:EICHHORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4071 TATES CREEK CENTRE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3062
Mailing Address - Country:US
Mailing Address - Phone:859-260-4330
Mailing Address - Fax:859-260-4334
Practice Address - Street 1:2101 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2518
Practice Address - Country:US
Practice Address - Phone:859-260-4330
Practice Address - Fax:859-260-4334
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY391522084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64096720Medicaid
KYK051590Medicare PIN