Individual
ALAN LEROY PROK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4619 KENNY RD, COLUMBUS, OH 43220-2779
(614) 457-8180
Mailing address
1 WYOMING ST, DAYTON, OH 45409-2722
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35085538
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2670917
—
OH
Enumeration date
05/10/2006
Last updated
06/02/2016
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