Provider Demographics
NPI:1063491355
Name:LOHANI, GOVINDA PRASAD (MD)
Entity Type:Individual
Prefix:DR
First Name:GOVINDA
Middle Name:PRASAD
Last Name:LOHANI
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 1:4020 RICHARDS RD STE C
Mailing Address - Street 2:
Mailing Address - City:N LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2744
Mailing Address - Country:US
Mailing Address - Phone:501-379-8115
Mailing Address - Fax:501-379-8075
Practice Address - Street 1:4020 RICHARDS RD STE C
Practice Address - Street 2:
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2744
Practice Address - Country:US
Practice Address - Phone:501-379-8118
Practice Address - Fax:501-379-8075
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5J841OtherBLUECROSS/BLUESHIELD
AR621679087OtherTRICARE
AR621679087OtherTRICARE/PRIME
AR0420106OtherUNITED HEALTHCARE
AR5J841OtherBLUECROSS
ARQUAL CHOICEOther16512000000
AR128198001Medicaid
AR136869002Medicaid
AR16512000000OtherQUAL CHOICE
AR2135835OtherCIGNA
AR16512000000OtherQUAL CHOICE
AR5J841Medicare ID - Type Unspecified
AR5J841OtherBLUECROSS