| Doctor Name: | KENNETH C PRATHER |
| NPI Number: | 1023086931 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | C5928 |
| Business Practice Address: | 700 W Grove St El Dorado, AR - 717304416 |
| Business Phone Number: | 8708632000 |
| Business Fax Number: | |
| Mailing Address: | 5220 Belfort Rd, Atten: Julie Kaye JACKSONVILLE |
| State: | FL |
| Postal Code: | 322566017 |
| Phone Number: | 9044463737 |
| Fax Number: | 9044463013 |
| NPI Enumeration Date: | 03/08/2006 |
| NPI Last Update Date: | 01/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C5928 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |