Healthcare Provider Details

I. General information

NPI: 1396239976
Provider Name (Legal Business Name): DAVID HARRIS PRATT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2018
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 AVENUE H
ELY NV
89301-2615
US

IV. Provider business mailing address

1500 AVENUE H
ELY NV
89301-2615
US

V. Phone/Fax

Practice location:
  • Phone: 775-289-3001
  • Fax:
Mailing address:
  • Phone: 775-289-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1396239976
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: