Dr Wallace Roy Pratt, MD is a
Allergy & Immunology physician based in Shawnee, Oklahoma. Dr Wallace Roy Pratt is licensed to practice in Oklahoma (license number 18812) and his current practice location is 3315 Kethley Rd, Shawnee, Oklahoma. He can be reached at his office (for appointments etc.) via phone at
(405) 273-5801.
NPI number for Dr Wallace Roy Pratt is 1831146851 and his current mailing address is Po Box 258884, Oklahoma City, Oklahoma. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1831146851.
Physician's Profile
| Full Name | Dr Wallace Roy Pratt |
|---|
| Gender | Male |
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| Speciality | Allergy & Immunology |
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| Location | 3315 Kethley Rd, Shawnee, Oklahoma |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1831146851
- Provider Enumeration Date: 05/27/2006
- Last Update Date: 11/11/2016
Medical Identifiers
Medical identifiers for Dr Wallace Roy Pratt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831146851 | NPI | - | NPPES |
| 100206950A | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207K00000X | Allergy & Immunology | 18812 (Oklahoma) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wallace Roy Pratt is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Wallace Roy Pratt, MD
Po Box 258884,
Oklahoma City, OK 73125-8884
Ph: (405) 231-3857 | Dr Wallace Roy Pratt, MD
3315 Kethley Rd,
Shawnee, OK 74804-9638
Ph: (405) 273-5801 |
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