Healthcare Provider Details

I. General information

NPI: 1578085262
Provider Name (Legal Business Name): JULIE M PRATT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 S 70TH ST STE 100
FORT SMITH AR
72903-5017
US

IV. Provider business mailing address

3111 S 70TH ST STE 100
FORT SMITH AR
72903-5017
US

V. Phone/Fax

Practice location:
  • Phone: 479-755-2652
  • Fax: 479-755-2519
Mailing address:
  • Phone: 479-755-2652
  • Fax: 479-755-2519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD11694
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: