Provider Demographics
NPI:1619959228
Name:REKHI, AVIN D (MD)
Entity Type:Individual
Prefix:DR
First Name:AVIN
Middle Name:D
Last Name:REKHI
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:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-0550
Mailing Address - Country:US
Mailing Address - Phone:479-463-7775
Mailing Address - Fax:479-463-7187
Practice Address - Street 1:813 FOUNDERS PARK DR E
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-6314
Practice Address - Country:US
Practice Address - Phone:479-463-2440
Practice Address - Fax:479-463-2465
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235081207RN0300X
ARE-2877207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200116080AMedicaid
NY000165018OtherEXCELLUS PROVIDER NUMBER
ARP00400596OtherRR MCR
NY02630835Medicaid
AR164498001Medicaid
AR5N826OtherAR BCBS
AR5N826Medicare PIN
NYRA6070Medicare ID - Type Unspecified
NY02630835Medicaid
AR5N826OtherAR BCBS
ARG33136Medicare UPIN