Healthcare Provider Details

I. General information

NPI: 1982205647
Provider Name (Legal Business Name): NEELKUMAR PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2020
Last Update Date: 11/07/2020
Certification Date: 11/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 W SUNSHINE ST
SPRINGFIELD MO
65807-0906
US

IV. Provider business mailing address

275 TANGER BLVD
BRANSON MO
65616-2186
US

V. Phone/Fax

Practice location:
  • Phone: 417-864-8006
  • Fax: 417-864-2844
Mailing address:
  • Phone: 865-410-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2020020853
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: