Healthcare Provider Details

I. General information

NPI: 1902425101
Provider Name (Legal Business Name): JOHN CASWELL PRATHER II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 MARKET BLVD STE 103
COLLIERVILLE TN
38017-2360
US

IV. Provider business mailing address

6077 E PRIMACY PKWY STE 140
MEMPHIS TN
38119-5754
US

V. Phone/Fax

Practice location:
  • Phone: 901-641-3000
  • Fax: 901-259-1698
Mailing address:
  • Phone: 901-725-8347
  • Fax: 901-259-7637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number247448
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: