Individual
DR. BRUCE EDWARD PRESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
805 N KENTUCKY ST, WEST PLAINS, MO 65775-2022
(417) 256-2111
(417) 256-4858
Mailing address
805 N KENTUCKY ST, WEST PLAINS, MO 65775-2022
(417) 256-2111
(417) 256-4858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R7937
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200952109
—
MO
05
—
599022307
—
MO
05
—
599022308
—
MO
01
—
P00207380
MEDICARE RR
—
Enumeration date
05/27/2005
Last updated
01/23/2008
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