Individual
DR. RONALD J PAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2364
(417) 820-7136
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
109763
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128989001
—
AR
05
—
208196808
—
MO
01
—
31827
MO BLUE SHIELD
MO
01
—
81702
ARK BLUE SHIELD
AR
Enumeration date
02/14/2007
Last updated
10/03/2014
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