Provider Demographics
NPI:1619117850
Name:KALIKI, GIRI VENKATA (MD,)
Entity Type:Individual
Prefix:DR
First Name:GIRI
Middle Name:VENKATA
Last Name:KALIKI
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:DR
Other - First Name:GIRIDHAR
Other - Middle Name:
Other - Last Name:KALIKIVENKATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5500 HIGHLAND DR
Mailing Address - Street 2:APT 1621
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-2051
Mailing Address - Country:US
Mailing Address - Phone:352-278-0688
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS WAY
Practice Address - Street 2:SUITE# 653
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-28
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE - 7574208000000X
FLME105735208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015069500Medicaid
FLIE703ZMedicare PIN