Provider Demographics
NPI:1669887311
Name:PRABHAKAR, HARI (MD)
Entity type:Individual
Prefix:DR
First Name:HARI
Middle Name:
Last Name:PRABHAKAR
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 1:13748 CINNABAR PL
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5342
Mailing Address - Country:US
Mailing Address - Phone:706-222-4559
Mailing Address - Fax:
Practice Address - Street 1:304 INSPERON DR
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-0605
Practice Address - Country:US
Practice Address - Phone:706-222-4559
Practice Address - Fax:706-400-6493
Is Sole Proprietor?:No
Enumeration Date:2014-06-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA274972207L00000X
TXS1493208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS1493OtherTX MEDICAL LICENSE