Active NPI
Rayford Lee Tackett
- Legal Medicine
- Clarksville, AR
National Provider Identifier
1295721702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- C8312
- Practice address
- 23 Professional Park Dr
Clarksville, AR 72830-4432 - Phone
- (479) 754-4721
- Fax
- (479) 754-7065
- NPI assigned
- Sep 21, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | C8312 | AR | Primary |
Addresses
Primary practice location
23 Professional Park Dr
Clarksville, AR 72830-4432
Mailing address
23 Professional Park Dr
Clarksville, AR 72830-4432
Phone (479) 754-4721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C8312 | AR | MD | Legal Medicine |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Regional Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1295721702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 PROFESSIONAL PARK DR",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728304432",
"telephone_number": "479-754-4721",
"fax_number": "479-754-7065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 PROFESSIONAL PARK DR",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728304432",
"telephone_number": "479-754-4721",
"fax_number": "479-754-7065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "RAYFORD",
"middle_name": "LEE",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "AR",
"license": "C8312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.