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Thomas R Prostko
Medical Specialty Clinic/Center in Easley, South Carolina
NPI 1780883942

Thomas R Prostko is a Medical Specialty Clinic/Center based in Easley, SC and is specialized in Medical Specialty. Thomas R Prostko practices in Easley, SC. The NPI Number for Thomas R Prostko is 1780883942 and holds a License No. 13970 (South Carolina).

The current practice location address for Thomas R Prostko is 403 Hillcrest Dr, Easley, SC and can be reached out via phone at 864-442-0771 and via fax at 864-442-0774.

Location: 403 Hillcrest Dr, Easley, SC, 29640-1207
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1780883942
Provider Name
Thomas R Prostko
Credential
Provider Entity Type
Organization
Address
403 Hillcrest Dr, Easley, SC, 29640-1207
Phone Number
864-442-0771
Fax Number
864-442-0774
Provider Enumeration Date
07/17/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GP3506 05 SC
institution
Provider Business Practice Location Address Details
Address
403 Hillcrest Dr
City
Easley
State
South Carolina
Zip
29640-1207
Phone Number
864-442-0771
Fax Number
864-442-0774
person
Provider Business Mailing Address Details
Address
403 Hillcrest Dr
City
Easley
State
South Carolina
Zip
29640-1207
Phone Number
864-442-0771
Fax Number
864-442-0774
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
13970 (South Carolina)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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