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Individual

DR. DAVE PRAKASH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5526 LAKE SIDE DR, BOSSIER CITY, LA 71111-5504
(315) 882-2278
Mailing address
PO BOX 184, BARKSDALE AFB, LA 71110-0184
(315) 882-2278

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
234586
NY

Other

Enumeration date
12/23/2010
Last updated
12/23/2010
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