Individual
DR. DONNA JACOBI PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9999 CHEMSTRAND RD, PENSACOLA, FL 32514-2724
(850) 479-4456
(850) 473-3986
Mailing address
8880 UNIVERSITY PKWY, SUITE A, PENSACOLA, FL 32514-4937
(850) 494-5939
(850) 494-5962
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
43401
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
4484
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009914935
—
AL
05
—
067241600
—
FL
Enumeration date
04/21/2011
Last updated
03/07/2023
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