Individual
DAVID PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 N 500 W STE 102, PROVO, UT 84604-3305
(801) 374-2367
Mailing address
1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01070213A
IN
2085R0001X
Radiation Oncology Physician
Primary
12568775-1205
UT
2085R0001X
Radiation Oncology Physician
2007029607
MO
2085R0001X
Radiation Oncology Physician
35093149
OH
2085R0001X
Radiation Oncology Physician
42433
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200975430
—
IN
05
—
2929835
—
OH
05
—
7100071100
—
KY
Enumeration date
09/26/2006
Last updated
06/20/2022
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