Provider Demographics
NPI:1386662203
Name:NAMBIAR, PRABHAKARAN K (MD)
Entity Type:Individual
Prefix:
First Name:PRABHAKARAN
Middle Name:K
Last Name:NAMBIAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3700 N WINDSONG DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-1253
Mailing Address - Country:US
Mailing Address - Phone:928-759-8800
Mailing Address - Fax:928-443-8941
Practice Address - Street 1:3700 N WINDSONG DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1253
Practice Address - Country:US
Practice Address - Phone:928-759-8800
Practice Address - Fax:804-861-0050
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2021-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA01010385792081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine