Healthcare Provider Details

I. General information

NPI: 1245233105
Provider Name (Legal Business Name): JOSEPH BRIAN PRIGG PA-C,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 WALMART DR STE A
CAMDEN DE
19934-1365
US

IV. Provider business mailing address

344 CHARLIES CT
FELTON DE
19943-5276
US

V. Phone/Fax

Practice location:
  • Phone: 302-698-4441
  • Fax:
Mailing address:
  • Phone: 302-922-2295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC50000284
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: