Provider Demographics
NPI:1790304368
Name:PRESCOTT, CAROLINE FULLER (MD)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:FULLER
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26194
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-2012
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-212-3718
Practice Address - Street 1:95 SEABOARD LN STE 2021
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3031
Practice Address - Country:US
Practice Address - Phone:615-261-1210
Practice Address - Fax:833-973-3532
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN67597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics