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General NPI Number Information
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NPI Number | 1912895483
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Entity Type | Individual
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Provider Name | RACHAEL ANN GRAHAM
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 8101 MCCLURE DR STE 101
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City | FORT SMITH
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State | AR
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Zip | 72916-6044
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Country | US
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Telephone | 479-652-0909
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 421
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City | FORT SMITH
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State | AR
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Zip | 72902-0421
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Country | US
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Telephone | 479-652-0909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471V0105X
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Taxonomy Name | Vascular Sonography Radiologic Technologist
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License Number |
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number |
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License Number State | AR
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