National Provider Identifier Database

THOMAS R PROSTKO
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

THOMAS R PROSTKO
403 HILLCREST DR
SUITE A
EASLEY, SC29640-1207
Phone: 864-442-0771
Fax: 864-442-0774
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for THOMAS R PROSTKO

NPI Number 1780883942
Legal business name
LBN
THOMAS R PROSTKO
Authorized official THOMAS PROSTKO - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 07/17/2007
Last updated 06/19/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • SC License #: 13970
  • SC Medicaid: GP3506

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.

Reviews for THOMAS R PROSTKO

There are currently no reviews for THOMAS R PROSTKO


NPIdb - Home
v2.201