Provider Demographics
NPI:1215565056
Name:GANDHI, PAYAL NITIN (MD)
Entity type:Individual
Prefix:DR
First Name:PAYAL
Middle Name:NITIN
Last Name:GANDHI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MIRAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-3200
Mailing Address - Country:US
Mailing Address - Phone:501-766-7501
Mailing Address - Fax:
Practice Address - Street 1:5 MEDICAL PARK DR STE GL2
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3745
Practice Address - Country:US
Practice Address - Phone:501-574-7237
Practice Address - Fax:844-453-4246
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-16335207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine