Individual
MARK EDWARD PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 STONECREST BLVD, SMYRNA, TN 37167-6810
(615) 768-2000
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37288
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3882213
—
TN
05
—
3882214
—
TN
01
—
4110138
BLUECROSS
TN
01
—
4150275
BLUECROSS
TN
01
—
P00330939
RAILROAD MEDICARE
TN
Enumeration date
06/15/2006
Last updated
11/12/2007
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