Individual
GORDON F PRESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
508 NEW HOPE RD STE 7, PRINCETON, WV 24740
(304) 431-7200
Mailing address
118 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 487-7936
(304) 487-7835
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10242
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080053000
—
WV
Enumeration date
08/20/2006
Last updated
09/25/2018
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