Individual
DR. JAMON R PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 MEDICAL CENTER PKWY, SUITE 240B, BENTONVILLE, AR 72712-3204
(479) 553-2200
(479) 553-2909
Mailing address
2900 MEDICAL CENTER PKWY, SUITE 240B, BENTONVILLE, AR 72712-3204
(479) 553-2200
(479) 553-2909
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
C8298
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100077970A
—
OK
05
—
135004001
—
AR
01
—
180380000
QUAL CHOICE
AR
01
—
1900365
UNITED HEALTHCARE
AR
05
—
204813307
—
MO
01
—
5005701
AETNA
AR
01
—
C8298
ARKANSAS STATE LICENSE
AR
Enumeration date
06/15/2006
Last updated
03/07/2023
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