Provider Demographics
NPI:1659439222
Name:GOVINDA LOHANI MD PA
Entity Type:Organization
Organization Name:GOVINDA LOHANI MD PA
Other - Org Name:GOVINDA LOHANI MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:GOVINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-379-8115
Mailing Address - Street 1:4020 RICHARDS RD STE C
Mailing Address - Street 2:
Mailing Address - City:N LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2744
Mailing Address - Country:US
Mailing Address - Phone:501-379-8115
Mailing Address - Fax:501-379-8075
Practice Address - Street 1:4020 RICHARDS RD STE C
Practice Address - Street 2:
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2744
Practice Address - Country:US
Practice Address - Phone:501-379-8115
Practice Address - Fax:501-379-8075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE0463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK00728092263OtherOK MEDICAID
AR128198001Medicaid
AR0420106OtherUNITEDHEALTHCARE
AR2135835OtherCIGNA
AR5J841OtherBLUECROSS
AR16512000000OtherQUAL CHOICE
AR5150543OtherAETNA
AR5J841OtherBLUESHEILD
AR136869002Medicaid
AR16512000000OtherQUAL CHOICE
AR5150543OtherAETNA
AR16512000000OtherQUAL CHOICE