Provider Demographics
NPI:1235345414
Name:PRATT, CEDRIC (DO)
Entity Type:Individual
Prefix:DR
First Name:CEDRIC
Middle Name:
Last Name:PRATT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5424
Mailing Address - Country:US
Mailing Address - Phone:501-327-4444
Mailing Address - Fax:501-327-3962
Practice Address - Street 1:9800 BAPTIST HEALTH DR STE 501
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-223-8400
Practice Address - Fax:501-223-3713
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE7421207WX0107X, 207WX0107X
OH58002038207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology