Basic Information
| Provider Information | |||||||||
| NPI: | 1396239976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRATT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | HARRIS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 AVENUE H | ||||||||
| Address2: | |||||||||
| City: | ELY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 893012615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752893001 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 AVENUE H | ||||||||
| Address2: | |||||||||
| City: | ELY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 893012615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752893001 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2018 | ||||||||
| LastUpdateDate: | 09/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1396239976 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.