Individual
PAUL PRACHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 MATTHEW ST, MARIETTA, OH 45750-1635
(740) 374-1410
(740) 374-1691
Mailing address
100 E CAMPUS VIEW BLVD, STE 160, COLUMBUS, OH 43235-4647
(614) 396-4750
(614) 396-4742
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35063757
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0119372000
—
WV
05
—
0891290
—
OH
01
—
300063737
MEDICARE RAILROAD
—
Enumeration date
06/07/2006
Last updated
03/21/2013
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