Provider Demographics
NPI:1497756852
Name:PIRACHA, ASIM R (MD)
Entity type:Individual
Prefix:DR
First Name:ASIM
Middle Name:R
Last Name:PIRACHA
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 1:2353 ALEXANDRIA DR STE 350
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3208
Mailing Address - Country:US
Mailing Address - Phone:859-224-2655
Mailing Address - Fax:859-223-7147
Practice Address - Street 1:2353 ALEXANDRIA DR STE 260
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3208
Practice Address - Country:US
Practice Address - Phone:859-224-2655
Practice Address - Fax:859-223-7147
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055599A207W00000X
KY32762207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000491263OtherANTHEM
KY1158406Medicaid
KY64046519Medicaid
KY2439268000Medicaid
IN200122930Medicaid
KY2439268000Medicaid
IN200122930Medicaid
KYP00360324Medicare ID - Type UnspecifiedRAILRAOD MEDICARE KENTUCK
INH20473Medicare UPIN
KY1158406Medicaid