Provider Demographics
NPI:1508931395
Name:RAINS, JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:RAINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72145-1198
Mailing Address - Country:US
Mailing Address - Phone:501-305-4068
Mailing Address - Fax:501-279-3760
Practice Address - Street 1:916A E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4617
Practice Address - Country:US
Practice Address - Phone:501-305-4068
Practice Address - Fax:501-279-3760
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE14732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133164001Medicaid
AR5K638Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE
AR133164001Medicaid