Provider Demographics
NPI:1073737532
Name:PRATT, JOHN WHETTEN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WHETTEN
Last Name:PRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4375
Mailing Address - Country:US
Mailing Address - Phone:717-697-1414
Mailing Address - Fax:717-697-4921
Practice Address - Street 1:890 CENTURY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4375
Practice Address - Country:US
Practice Address - Phone:717-697-1414
Practice Address - Fax:717-697-4921
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-442545207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02286000OtherCAPITAL BLUE CROSS
PA727679OtherBLUE SHIELD
PACF0050OtherRAILROAD MEDICARE
PA232175708OtherOTHER
PA727679OtherBLUE SHIELD
PA02286000OtherCAPITAL BLUE CROSS
PA727679Medicare PIN