Kenneth C Prather
General Practice Physician
700 W Grove St
El Dorado
, Arkansas 71730-4416
Kenneth C Prather
General Practice Physician
700 W Grove St
El Dorado
, Arkansas 71730-4416
(904) 446-3013
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Kenneth C Prather
- 5220 Belfort Rd Atten: Julie Kaye
- Jacksonville, FL
- Zip : 32256-6017
- Fax : (904) 446-3013
- Phone : (904) 446-3737
Second Address
- Kenneth C Prather
- 700 W Grove St
- El Dorado, AR
- Zip : 71730-4416
- Phone : (870) 863-2000
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | C5928 | AR |
National Provider Identifier
| NPI | 1023086931 |
|---|---|
| Provider Name | Kenneth C Prather |
| First Address | Jacksonville, FL 32256-6017 |
| Second Address | El Dorado, AR 71730-4416 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/03/2006 |
| Last Update Date | 27/01/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 106158001 | (05) | AR |
| 54158 | BLUE CROSS (01) | AR |
| B90494 | (02) | AR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.