Provider Demographics
NPI:1306171236
Name:RACKARD, RACHEL ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:RACKARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40870 AL HIGHWAY 69 STE A
Mailing Address - Street 2:
Mailing Address - City:MOUNDVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35474-4367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40870 AL HIGHWAY 69 STE A
Practice Address - Street 2:
Practice Address - City:MOUNDVILLE
Practice Address - State:AL
Practice Address - Zip Code:35474-4367
Practice Address - Country:US
Practice Address - Phone:205-371-4444
Practice Address - Fax:205-371-8745
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9709101YM0800X
FLME147030207Q00000X
ALMD.37318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health