Dr. Mark Linden Prohaska, Ph.D.
Clinical Neuropsychologist in Tuscaloosa, AL. Individual provider (NPI-1).
NPI number1073663555
StatusActive
Last updated in NPPESFeb 6, 2009
Details
- NPI
- 1073663555
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark Linden Prohaska
- Credential
- Ph.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 10, 2007
- Last updated
- Feb 6, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 816 | AL | Yes |
| 103T00000X | Psychologist | 816 | AL |
Practice location
100 Rice Mine RoadSuite 303
Tuscaloosa, AL 35406
Phone 205-344-6169 · Fax 205-344-6171
Mailing address
100 Rice Mine RoadSuite 303
Tuscaloosa, AL 35406
Phone 205-344-6169 · Fax 205-344-6171
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