Organization
THOMAS R PROSTKO
Active
Other names
Easley Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R. PROSTKO M.D. (OWNER)
(864) 442-0771
Entity
Organization
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
(864) 442-0774
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
13970
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3506
—
SC
Enumeration date
07/17/2007
Last updated
06/19/2008
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