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Contact Information

THOMAS R PROSTKO, MD
403 HILLCREST DR
SUITE A
EASLEY, SC29640-1207
 Phone: 864-442-0771
 Fax: 864-442-0774
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
Indicates primary specialty

NPI Profile & details for THOMAS R PROSTKO · (Male)

NPI Number 1417928243
Status Active
Credentials MD
Entity Individual
Enumeration date 01/30/2006
Last updated 07/23/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # 13970
  • SC Medicaid GP3506
Hospital affiliation(s)
  • CANNON MEMORIAL HOSPITAL - (Acute Care)
    123 MEDICAL PARK DRIVE PO BOX 188
    PICKENS, SC 29671
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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