Provider Demographics
NPI:1851355333
Name:DE HOYOS, ALBERTO L (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:L
Last Name:DE HOYOS
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 1:740 SOUTH LIMESTONE
Mailing Address - Street 2:ROOM A301
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536
Mailing Address - Country:US
Mailing Address - Phone:859-323-6494
Mailing Address - Fax:
Practice Address - Street 1:740 SOUTH LIMESTONE
Practice Address - Street 2:ROOM A301
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-6494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-103013208G00000X
LAMD.207423208G00000X
KY48484208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103013Medicaid
LA2378350Medicaid
MS05979548Medicaid
IL036103013Medicaid
H91399Medicare UPIN
LA375629YH3UMedicare PIN