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NPI 1194251462

NPI 1194251462 : JOHN FRANCIS PRATER : TREXLERTOWN, PA

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General NPI Number Information
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    NPI Number           |    1194251462
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN FRANCIS PRATER
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/05/2017
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    Last Update Date     |    08/17/2020
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Provider Practice Location Address
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    Address Line         |    6900 HAMILTON BLVD 
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    City                 |    TREXLERTOWN
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    State                |    PA
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    Zip                  |    18087-9101
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    Country              |    US
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    Telephone            |    610-402-0101
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2100 MACK BLVD 
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    City                 |    ALLENTOWN
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    State                |    PA
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    Zip                  |    18103-5622
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    Country              |    US
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    Telephone            |    484-884-0617
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    Fax                  |    484-884-0628
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    MD470172
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    License Number State |    PA
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