Provider Demographics
NPI:1457471559
Name:PROKOP, TARA N (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:N
Last Name:PROKOP
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6880 S MCCARRAN BLVD
Mailing Address - Street 2:#12
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6104
Mailing Address - Country:US
Mailing Address - Phone:775-329-5555
Mailing Address - Fax:775-827-5596
Practice Address - Street 1:6880 S MCCARRAN BLVD
Practice Address - Street 2:#12
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6104
Practice Address - Country:US
Practice Address - Phone:775-329-5555
Practice Address - Fax:775-827-5596
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV11078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics