Provider Demographics
NPI:1235557158
Name:PRATT, SUZANNE G (MD)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:G
Last Name:PRATT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 JOHN MADDOX DR NW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-1451
Mailing Address - Country:US
Mailing Address - Phone:706-234-0034
Mailing Address - Fax:706-234-0033
Practice Address - Street 1:109 JOHN MADDOX DR NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1451
Practice Address - Country:US
Practice Address - Phone:706-234-0034
Practice Address - Fax:706-234-0033
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2014-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16412207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology