Organization
PRATT FAMILY PRACTICE LLC
Active
Other names
Pratt Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
WAKON FOWLER M.D. (MEDICAL DIRECTOR)
(620) 672-7422
Entity
Organization
Contact information
Practice address
203 WATSON ST, SUITE 200, PRATT, KS 67124-3066
(620) 672-7422
(620) 508-6476
Mailing address
203 WATSON ST, SUITE 200, PRATT, KS 67124-3066
(620) 672-7422
(620) 508-6476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110446
GROUP NUMBER
KS
01
—
17-8987
RHC PROVIDER #
KS
Enumeration date
05/18/2006
Last updated
07/16/2015
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