Provider Demographics
NPI:1487477279
Name:PRESCOTT, ROY WILLIAM JR (PA-C)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:WILLIAM
Last Name:PRESCOTT
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2727 S 144TH ST STE 280
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5252
Mailing Address - Country:US
Mailing Address - Phone:402-745-1145
Mailing Address - Fax:833-985-0140
Practice Address - Street 1:2727 S 144TH ST STE 280
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5252
Practice Address - Country:US
Practice Address - Phone:402-745-1145
Practice Address - Fax:833-985-0140
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2025-04-23
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant