Individual
DR. HOSAMANE S PRABHAKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 EAST HOSPITAL ROAD, EISHENHOWER MEDICAL CTR, FORT GORDON, GA 30905-5650
(706) 787-9123
Mailing address
756 PENINSULA OVERLOOK, HAMPTON, GA 30228-6062
(229) 869-0756
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
042394
GA
208000000X
Pediatrics Physician
042394
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00758458A
—
GA
Enumeration date
02/10/2006
Last updated
04/23/2024
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