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Individual

JONATHAN BRENT PRATHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2949 S UNION ST, OPELOUSAS, LA 70570-5740
(337) 948-9606
(337) 948-7003
Mailing address
2949 S UNION ST, OPELOUSAS, LA 70570-5740
(337) 948-9606
(337) 948-7003

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
014301
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1301833
LA
Enumeration date
07/13/2006
Last updated
09/19/2019
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