Provider Demographics
NPI:1982205647
Name:PATEL, NEELKUMAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NEELKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 TANGER BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2186
Mailing Address - Country:US
Mailing Address - Phone:865-410-6542
Mailing Address - Fax:
Practice Address - Street 1:3520 W SUNSHINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-0906
Practice Address - Country:US
Practice Address - Phone:417-864-8006
Practice Address - Fax:417-864-2844
Is Sole Proprietor?:No
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020020853183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist