Provider Demographics
NPI:1942269188
Name:KAZAKEVICIUS, RIMANTAS (MD)
Entity type:Individual
Prefix:
First Name:RIMANTAS
Middle Name:
Last Name:KAZAKEVICIUS
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 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-627-1800
Mailing Address - Fax:501-627-1899
Practice Address - Street 1:1424 TANNER ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:AR
Practice Address - Zip Code:72104-2082
Practice Address - Country:US
Practice Address - Phone:501-332-8612
Practice Address - Fax:501-332-4141
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136709001Medicaid
ARG88228Medicare UPIN
ARG88228Medicare UPIN