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Individual

DR. JERRY W PRATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1722 SHAFFER ST, KALAMAZOO, MI 49048-1633
(269) 343-1555
Mailing address
5943 STADIUM DR, KALAMAZOO, MI 49009-3016
(804) 334-2908

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
0101239206
VA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
17033
MS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
35067178
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301100380
MI

Other

Enumeration date
02/28/2006
Last updated
04/09/2015
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