Individual
DR. DARRELL SCOTT PRESTRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0502
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000094295
—
AL
01
—
515-33912
BC BS OF AL
AL
Enumeration date
07/27/2005
Last updated
12/01/2015
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