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Individual

TIMOTHY JAMES PRATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1011 BOWLES AVENUE, SUITE 121, FENTON, MO 63026
(314) 766-2066
(636) 326-1802
Mailing address
PO BOX 220375, KIRKWOOD, MO 63122-0375
(314) 766-2066
(636) 326-1802

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
R9E55
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202477915
MO
Enumeration date
05/25/2006
Last updated
06/19/2024
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