Provider Demographics
NPI:1952490328
Name:SURENDHER LOKAREDDY MDPC
Entity Type:Organization
Organization Name:SURENDHER LOKAREDDY MDPC
Other - Org Name:ASSOCIATES FOR WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOKAREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-341-4650
Mailing Address - Street 1:1945 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6105
Mailing Address - Country:US
Mailing Address - Phone:928-341-4650
Mailing Address - Fax:928-341-9779
Practice Address - Street 1:1945 W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6105
Practice Address - Country:US
Practice Address - Phone:928-341-4650
Practice Address - Fax:928-341-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7451176B00000X
AZ7222176B00000X
AZAP3863176B00000X
AZ22345207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ167082Medicaid
AZ573739Medicaid
AZ342147Medicaid
AZ4280300OtherDR. LOKAREDDY CIGNA ID
AZ629222OtherDR. LOKAREDDY AETNA ID
AZ825523Medicaid
AZ350116Medicaid
AZAZ0376540OtherDR. LOKAREDDY BCBS ID
AZ350116Medicaid
AZ167082Medicaid