Healthcare Provider Details

I. General information

NPI: 1245641315
Provider Name (Legal Business Name): RACHEL SPOONER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL ALLEN

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 11/27/2023
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8890 E 116TH ST STE 300
FISHERS IN
46038-2857
US

IV. Provider business mailing address

1125 N COLLEGE AVE
FAYETTEVILLE AR
72703-1908
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-1500
  • Fax: 317-621-1509
Mailing address:
  • Phone: 479-713-8000
  • Fax: 479-444-7820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-9664
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberE-9664
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01078117A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: