Provider Demographics
NPI:1215007968
Name:LANKA, JHANSI (MD)
Entity Type:Individual
Prefix:
First Name:JHANSI
Middle Name:
Last Name:LANKA
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 1:1476 FOREST HILLS RD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41527-8333
Mailing Address - Country:US
Mailing Address - Phone:606-237-1121
Mailing Address - Fax:
Practice Address - Street 1:859 ALDERSON ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3215
Practice Address - Country:US
Practice Address - Phone:304-235-2500
Practice Address - Fax:304-235-4549
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20584207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3002883000Medicaid
KY64038359Medicaid
WV3002883000Medicaid
WVGU4095301Medicare ID - Type Unspecified