Individual
MR. TIMOTHY ALAN PRESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
122 12TH STREET EXT, PRINCETON COMMUNITY HOSPITAL, PRINCETON, WV 24740-2352
(304) 487-7275
(304) 487-7153
Mailing address
112 12TH ST, PRINCETON, WV 24740-2312
(865) 985-7258
(865) 985-7077
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
934
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001902890
BLUE CROSS
WV
01
—
P00241089
MEDICARE RAILROAD
WV
Enumeration date
06/12/2006
Last updated
10/20/2017
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