Organization
DON L. PRUITT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DON LEE PRUITT MD (DOCTOR)
(706) 754-1421
Entity
Organization
Contact information
Practice address
3693 STATE HIGHWAY 60, SUCHES, GA 30572-2921
(706) 747-1421
(706) 747-1423
Mailing address
3693 STATE HIGHWAY 60, PO BOX 59, SUCHES, GA 30572-2921
(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
01
—
08
MEDICARE PROVIDER ID
GA
Enumeration date
10/05/2007
Last updated
10/05/2007
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