Provider Demographics
NPI:1851395560
Name:PRATT, MICHAEL FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCES
Last Name:PRATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 HERITAGE WALK
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:770-516-0661
Mailing Address - Fax:770-928-9040
Practice Address - Street 1:281 HERITAGE WALK
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188
Practice Address - Country:US
Practice Address - Phone:770-516-0661
Practice Address - Fax:770-928-9040
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA041930207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA04BDCFLMedicare PIN
GAE12657Medicare UPIN