Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | OT013997 | PA |
NPI | 1013299684 |
---|---|
Provider Name | Casey Joseph Prather |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Lancaster, PA 17603-3363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2011 |
Last Update Date | 03/07/2017 |