Individual
DR. JAMON R PRUITT
Active
Individual
DR. JAMON R PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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