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General NPI Number Information
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NPI Number | 1396773669
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Entity Type | Individual
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Provider Name | KEITH PRATT MD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 65 PAYNE RD
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City | MOSHEIM
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State | TN
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Zip | 37818-3206
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Country | US
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Telephone | 423-422-4125
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Fax | 423-422-4126
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Provider Business Mailing Address
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Address Line | 360 CANEY CREEK RD
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City | ROGERSVILLE
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State | TN
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Zip | 37857-7600
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Country | US
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Telephone |
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 20992
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License Number State | TN
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