Individual
THOMAS RICHARD PROSTKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
403 HILLCREST DR, SUITE A, EASLEY, SC 29640-1207
(864) 442-0771
(864) 442-0774
Mailing address
403 HILLCREST DR, SUITE A, EASLEY, SC 29640-1207
(864) 442-0771
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
13970
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3506
—
SC
Enumeration date
01/30/2006
Last updated
07/23/2007
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