Provider Demographics
NPI:1619066214
Name:MOHANA R ARLA MD PSC
Entity Type:Organization
Organization Name:MOHANA R ARLA MD PSC
Other - Org Name:MD MOBILE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAVEEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ARLA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:502-955-4889
Mailing Address - Street 1:170 DR ARLA WAY
Mailing Address - Street 2:SUITE101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-5427
Mailing Address - Country:US
Mailing Address - Phone:502-955-4889
Mailing Address - Fax:
Practice Address - Street 1:170 DR ARLA WAY
Practice Address - Street 2:SUITE101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-5427
Practice Address - Country:US
Practice Address - Phone:502-955-4889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYG95106Medicare UPIN
KYC74082Medicare UPIN