Individual
DR. GEORGE M PRACKUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-2803
(860) 679-2784
(860) 679-4126
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
(860) 679-2784
(860) 679-4126
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
035567
CT
2085R0202X
Diagnostic Radiology Physician
231576-1
NY
2085R0202X
Diagnostic Radiology Physician
25MA12301500
NJ
2085R0202X
Diagnostic Radiology Physician
60600
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088945
—
IL
05
—
34584200
—
WI
Enumeration date
07/19/2006
Last updated
06/18/2026
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