Healthcare Provider Details

I. General information

NPI: 1811559750
Provider Name (Legal Business Name): PRAKASH ADHIKARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 PRINCE AVE STE 201
ATHENS GA
30606-2789
US

IV. Provider business mailing address

PO BOX 13579
READING PA
19612-3579
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-7055
  • Fax:
Mailing address:
  • Phone: 846-281-3244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD477640
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11622
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: