Provider Demographics
NPI:1730276379
Name:PRATT, PATRICIA M (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:PRATT
Suffix:
Gender:F
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:PO BOX 338
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-0338
Mailing Address - Country:US
Mailing Address - Phone:802-439-5321
Mailing Address - Fax:802-439-6783
Practice Address - Street 1:720 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:EAST CORINTH
Practice Address - State:VT
Practice Address - Zip Code:05040-0000
Practice Address - Country:US
Practice Address - Phone:802-439-5321
Practice Address - Fax:802-439-6783
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7691173000000X
VT042.0015605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHB86173Medicare UPIN
NHNH9885Medicare ID - Type Unspecified