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General NPI Number Information
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NPI Number | 1699046854
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Entity Type | Individual
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Provider Name | MATTHEW PRAZAK NP-C
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Gender | Male
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 721 MIAMI CHAPEL RD
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City | DAYTON
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State | OH
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Zip | 45417-4650
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Country | US
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Telephone | 937-281-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 275 ESSEX DR
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City | TIPP CITY
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State | OH
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Zip | 45371-2237
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Country | US
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Telephone | 575-252-3677
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0039181
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License Number State | OH
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