Provider Demographics
NPI:1265662969
Name:EDALA, ARPANA (MD)
Entity Type:Individual
Prefix:
First Name:ARPANA
Middle Name:
Last Name:EDALA
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 1:1509 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-3718
Mailing Address - Country:US
Mailing Address - Phone:379-919-2763
Mailing Address - Fax:
Practice Address - Street 1:2300 ANDOVER CT STE 400
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-3990
Practice Address - Country:US
Practice Address - Phone:501-904-5159
Practice Address - Fax:501-904-5157
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6496207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine