Provider Demographics
NPI:1326066960
Name:PRATHER, HEIDI (DO)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:
Last Name:PRATHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8233
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-747-2500
Mailing Address - Fax:314-747-2598
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-747-2500
Practice Address - Fax:314-747-2598
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO116666208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILENROLLEDMedicaid
MO243848215Medicaid
MO083010232Medicare PIN
MO083010232Medicaid