Healthcare Provider Details

I. General information

NPI: 1679780969
Provider Name (Legal Business Name): KALYAN AKKINENI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CHAD COLLEY BLVD
FORT SMITH AR
72916-6175
US

IV. Provider business mailing address

5808 CALLAWAY LN
FORT SMITH AR
72916-8437
US

V. Phone/Fax

Practice location:
  • Phone: 479-242-4455
  • Fax: 479-974-4570
Mailing address:
  • Phone: 423-426-3918
  • Fax: 479-974-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-5691
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberE-5691
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: