Provider Demographics
NPI:1972766475
Name:VINODRAI B LAKHANI MD
Entity Type:Organization
Organization Name:VINODRAI B LAKHANI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINODRAI
Authorized Official - Middle Name:BHAGWANJI
Authorized Official - Last Name:LAKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-768-7384
Mailing Address - Street 1:4840 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1310
Mailing Address - Country:US
Mailing Address - Phone:304-768-7384
Mailing Address - Fax:304-768-3377
Practice Address - Street 1:4840 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1310
Practice Address - Country:US
Practice Address - Phone:304-768-7384
Practice Address - Fax:304-768-3377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0055556000Medicaid
WV0055556000Medicaid
WVLA0420091Medicare PIN