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NPI Code Detail

MEDICARE: GEETHA CHANDRASHEKAR M.D.

MEDICARE: GEETHA CHANDRASHEKAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2019009736MO

General Provider Information

NPI Number : 1205203056
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEETHA CHANDRASHEKAR M.D.
Provider Business Mailing Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5011
Provider Business Practice Location Address
First Line : 210 N WILLIAMS ST UNIT C
Second Line :
City : MOBERLY
State : MO
Zip : 65270-1583
Country : US
Telephone Number : 660-263-7651
Fax Number : 660-263-2815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2015
Last Update Date : 03/03/2024

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