Healthcare Provider Details

I. General information

NPI: 1689245441
Provider Name (Legal Business Name): RAKESH SHETTY RAJALBANDI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2021
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6316
US

IV. Provider business mailing address

9600 BAPTIST HEALTH DR STE 320
LITTLE ROCK AR
72205-6322
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-2000
  • Fax:
Mailing address:
  • Phone: 501-227-0421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE20352
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: