MEDICARE: MRS. KALAIVANI SIVAKUMAR M.D.,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	E-14749	AR
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	E-14749	AR
3	207RC0000X	Cardiovascular Disease Physician	E-14749	AR

General Provider Information

NPI Number	:	1548674583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KALAIVANI SIVAKUMAR M.D.,

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST # 783
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:	501-526-5148

Provider Business Practice Location Address
First Line	:	4301 W MARKHAM ST # 532
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-5311
Fax Number	:	501-686-5935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	03/03/2026

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