Prater, Blake

Prater, Blake is an individual health care provider with primary practice located at 609 W 3Rd St , Imboden AR 72434-9099. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Prater, Blake can be contacted via phone (870) 869-1500.

Contact Information

Primary practice address
609 W 3Rd St Imboden AR 72434-9099
Phone: (870) 869-1500
Fax: (870) 869-1505
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1962730937
LBN Legal business name Prater, Blake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2009
Last updated Dec 2nd, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1962730937 NPPES
Arkansas MEDICAID 169332795

Popular Providers