Individual
DR. LANDON S PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5995 SPRING CREEK RD, ROCKFORD, IL 61114-6481
(815) 977-4403
(815) 977-5796
Mailing address
5995 SPRING CREEK RD, ROCKFORD, IL 61114-6481
(815) 977-4403
(815) 977-5796
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036124349
IL
208200000X
Plastic Surgery Physician
A99159
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124349
—
IL
01
—
10132215
BCBS
IL
Enumeration date
05/17/2007
Last updated
06/26/2019
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