| Organization Name: | KENNETH C. PRATHER, M.D., P.A. |
| NPI Number: | 1992079917 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH C PRATHER (PHYSICIAN) |
| Mailing Address: | 460 W Oak El Dorado |
| State: | AR US |
| Postal Code: | 717308525 |
| Phone Number: | 8708645490 |
| Fax Number: | 8708645494 |
| NPI Enumeration Date: | 03/08/2012 |
| NPI Last Update Date: | 03/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C-5928 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |