Individual
RAYMUND RABARA TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3023 S FORT AVE STE B, SPRINGFIELD, MO 65807-4217
(417) 605-7100
(417) 708-0889
Mailing address
2864 S NETTLETON AVE, SPRINGFIELD, MO 65807-5970
(417) 605-7100
(417) 708-0889
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2009014116
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780876227
—
MO
01
—
P01074413
RAILROAD MEDICARE
MO
Enumeration date
08/17/2007
Last updated
03/18/2026
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