Healthcare Provider Details

I. General information

NPI: 1285675868
Provider Name (Legal Business Name): DAVID PRESCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 E CAMPUS VIEW BLVD STE 180
COLUMBUS OH
43235-5616
US

IV. Provider business mailing address

355 E CAMPUS VIEW BLVD STE 180
COLUMBUS OH
43235-5616
US

V. Phone/Fax

Practice location:
  • Phone: 614-840-1688
  • Fax: 614-840-1689
Mailing address:
  • Phone: 614-840-1688
  • Fax: 614-840-1689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.047519
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: