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Individual

DAVID N PROCKNOW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1257
(541) 471-3455
Mailing address
1701 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1257

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD16495
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028642
OR
Enumeration date
11/30/2006
Last updated
12/30/2019
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