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Individual

HEIDI D PRATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
604 S MAIN ST, WATER VALLEY, MS 38965-3468
(662) 473-1311
(662) 473-2489
Mailing address
PO BOX 728, WATER VALLEY, MS 38965-0728
(662) 473-1311
(662) 473-2489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS9122
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
06075268
MS
05
273887200
FL
Enumeration date
04/11/2006
Last updated
06/28/2010
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