Individual
ERIC MARTIN CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
3801 S NATIONAL AVE, WEST TOWER, SUITE 700, SPRINGFIELD, MO 65807-5210
(417) 885-3888
(417) 520-5959
Mailing address
PO BOX 4024, SPRINGFIELD, MO 65808-4024
(417) 885-3888
(417) 881-7638
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2010008194
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2010008194
BOARD CERTIFIATION
MO
01
—
431560263
TRICARE
MO
01
—
P01050641
MCR RR
MO
Enumeration date
05/30/2006
Last updated
10/04/2021
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