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General NPI Number Information
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NPI Number | 1720011323
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Entity Type | Organization
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Legal Business Name | JONATHAN BRENT PRATHER, M.D., APMC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 200 PETROLEUM DR
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City | LAFAYETTE
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State | LA
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Zip | 70508-3880
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Country | US
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Telephone | 337-988-9999
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Fax | 337-989-2211
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Provider Business Mailing Address
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Address Line | 2949 S UNION ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-5740
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Country | US
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Telephone | 337-948-9606
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Fax | 337-989-2211
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBBIE PIERCE
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Credential |
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Telephone | 337-948-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 014301
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License Number State | LA
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