Provider Demographics
NPI:1962063081
Name:LOKINENI, SRAVANI
Entity type:Individual
Prefix:
First Name:SRAVANI
Middle Name:
Last Name:LOKINENI
Suffix:
Gender:F
Credentials:
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 632111
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2306
Mailing Address - Country:US
Mailing Address - Phone:812-450-6879
Mailing Address - Fax:
Practice Address - Street 1:340 STARLITE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-6102
Practice Address - Country:US
Practice Address - Phone:812-426-9311
Practice Address - Fax:812-858-4535
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-28
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY58710207RR0500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program