MEDICARE: DR. JOSEPH L PRATT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	11767	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00139098	OTHER	MS	RAILROAD MEDICARE ID #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	11767	OTHER	MS	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1417953233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH L PRATT MD

Provider Business Mailing Address
First Line	:	121 PRATT DR
Second Line	:	SUITE 1A
City	:	CORINTH
State	:	MS
Zip	:	38834-6026
Country	:	US
Telephone Number	:	662-286-0088
Fax Number	:	662-286-0067

Provider Business Practice Location Address
First Line	:	121 PRATT DR
Second Line	:	SUITE 1A
City	:	CORINTH
State	:	MS
Zip	:	38834-6026
Country	:	US
Telephone Number	:	662-286-0088
Fax Number	:	662-286-0067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	01/17/2014

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Directions to “ DR. JOSEPH L PRATT MD” Practice Location

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