Individual
DR. PRAVEEN CHANDRA PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Mailing address
PO BOX 844715, KANSAS CITY, MO 64184-4715
(417) 761-5214
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2021047776
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001903543
—
PA
Enumeration date
03/16/2006
Last updated
02/21/2025
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