Individual
DON L PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. PROF.CORP.
Contact information
Practice address
56 FIREWATER LN, SUCHES, GA 30572-2941
(706) 747-1421
(706) 747-1423
Mailing address
PO BOX 59, SUCHES, GA 30572-0059
(706) 747-1421
(706) 747-1423
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
019982
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000192255F
—
GA
Enumeration date
10/23/2006
Last updated
09/30/2013
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