Healthcare Provider Details
I. General information
NPI: 1811315310
Provider Name (Legal Business Name): RACHEL A MCKELVY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/01/2014
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 GENE GEORGE BLVD
SPRINGDALE AR
72762-0845
US
IV. Provider business mailing address
1 CHILDRENS WAY # 844
LITTLE ROCK AR
72202-3500
US
V. Phone/Fax
- Phone: 479-725-6801
- Fax: 479-725-6577
- Phone: 501-364-2090
- Fax: 501-364-3929
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | E10525 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | E-10525 |
| License Number State | AR |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | E-10525 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: