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General NPI Number Information
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NPI Number | 1073002077
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Entity Type | Individual
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Provider Name | NICHOLAS PRAYSON
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Gender | Male
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 546 WINTER ST # 200, WOOSTER, OH 44691
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City | WOOSTER
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State | OH
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Zip | 44691
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Country | US
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Telephone | 330-202-5580
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Fax |
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Provider Business Mailing Address
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Address Line | 6605 PARK POINTE CT
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City | PEPPER PIKE
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State | OH
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Zip | 44124-5399
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Country | US
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Telephone | 216-978-4005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35.148582
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 35.148582
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 35.148582
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 35.148582
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License Number State | OH
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