Healthcare Provider Details

I. General information

NPI: 1639009236
Provider Name (Legal Business Name): DAVID CHARLES PRAWD DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N MARKET ST
CHATTANOOGA TN
37405-3905
US

IV. Provider business mailing address

453 AIR CASTLE DR
TRENTON GA
30752-3104
US

V. Phone/Fax

Practice location:
  • Phone: 423-752-8104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6984
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: