Basic Information
Provider Information | |||||||||
NPI: | 1649214891 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SONI | ||||||||
FirstName: | ARUNA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 90 JACKSON PIKE | ||||||||
Address2: |   | ||||||||
City: | GALLIPOLIS | ||||||||
State: | OH | ||||||||
PostalCode: | 456311560 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7404465890 | ||||||||
FaxNumber: | 7404465532 | ||||||||
Practice Location | |||||||||
Address1: | 280 PATTONSVILLE RD | ||||||||
Address2: |   | ||||||||
City: | JACKSON | ||||||||
State: | OH | ||||||||
PostalCode: | 456409452 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7403958805 | ||||||||
FaxNumber: | 7403958855 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/16/2006 | ||||||||
LastUpdateDate: | 08/30/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-05-4745 | OH | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 1649214891 | 01 |   | NPI | OTHER | 3810004340 | 05 | WV |   | MEDICAID | 000000181663 | 01 | OH | UNISON MEDICAID | OTHER | 0647750 | 01 | OH | MOLINA MEDICAID | OTHER | 310917085082 | 01 | OH | CARESOURCE MEDICAID | OTHER | 000000484524 | 01 |   | ANTHEM BCBS | OTHER | P00170932 | 01 |   | RR MEDICARE | OTHER |