Provider Demographics
NPI:1972867240
Name:MISHRA, PRABHAT (MD)
Entity Type:Individual
Prefix:
First Name:PRABHAT
Middle Name:
Last Name:MISHRA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:1 CHILDRENS WAY # 203
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1100
Practice Address - Fax:501-364-4082
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2020-07-23
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Provider Licenses
StateLicense IDTaxonomies
MO2012018936207LP3000X
MS26070207LP3000X
ARE-13412207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology