Provider Demographics
NPI:1720039332
Name:MERHY, JAMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:
Last Name:MERHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 LEXINGTON AVENUE, SUITE 220
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-2873
Mailing Address - Country:US
Mailing Address - Phone:606-327-0055
Mailing Address - Fax:606-327-0054
Practice Address - Street 1:2195 HARRODSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3543
Practice Address - Country:US
Practice Address - Phone:859-323-2232
Practice Address - Fax:859-257-1078
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
KY35700207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00424672OtherRAILROAD MEDICARE
OH2274784Medicaid
WV3810001122Medicaid
KY64040769Medicaid
KY00412001Medicare PIN
P00424672OtherRAILROAD MEDICARE