Individual
CLINTON E PRESTON
Active
Individual
CLINTON E PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
6238A
WY
207P00000X
Emergency Medicine Physician
Primary
MD172857
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057811
—
MT
01
—
080179382
RAILROAD MEDICARE
WY
05
—
114905900
—
WY
01
—
311187
BLUE CROSS BLUE SHIELD
WY
Enumeration date
10/17/2005
Last updated
08/10/2015
Update your record
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