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Individual

WINSTON SILVESTER JOHNSON PRESCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3412 HILLSIDE DR, DEL CITY, OK 73115-1742
(229) 292-3932
Mailing address
3412 HILLSIDE DR, DEL CITY, OK 73115-1742
(229) 292-3932

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669820049
OK
Enumeration date
05/26/2016
Last updated
06/15/2016
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