Provider Demographics
NPI:1598731259
Name:LOCHALA, RICHARD MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARK
Last Name:LOCHALA
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 1:1102 CRESTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-5513
Mailing Address - Country:US
Mailing Address - Phone:479-394-7301
Mailing Address - Fax:479-394-7160
Practice Address - Street 1:1102 CRESTWOOD CIR
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-5513
Practice Address - Country:US
Practice Address - Phone:479-394-7301
Practice Address - Fax:479-394-7160
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-7308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR080127748OtherRAILROAD MEDICARE
AR390989OtherHEALTHLINK
AR7879080P01OtherCIGNA
OK100077250 AMedicaid
ARP03477OtherNOVASYS
AR117282001Medicaid
AR53482OtherBCBS PROVIDER #
AR200693200OtherUSDF NUMBER
OK100077250 AMedicaid
AR53482Medicare PIN