Organization Name:  JONATHAN BRENT PRATHER, M.D., APMC


Practice Location:
2949 S UNION ST  OPELOUSAS, LA 70570 US
Tel: 337-948-9606  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	LA	014301

Other Provider Identifiers:

Issuer	Number	State	Type
	1940402	LA	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin