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Individual

DR. GENE DAVID PRENDERGAST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4485 S 1-19 FRONTAGE ROAD, SUITE 100, GREEN VALLEY, AZ 85614
(866) 974-2673
(866) 939-2673
Mailing address
18444 N 25TH AVE, SUITE 310, PHOENIX, AZ 85023-1261
(866) 974-2673
(866) 939-2673

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A-1607-11
NM

Other

Enumeration date
01/11/2007
Last updated
10/22/2015
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