Individual
DR. BILLY D PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15TH MDG, 755 SCOTT CIRCLE, JBPH-HICKAM, HI 96853
(808) 448-6371
Mailing address
15TH MDG, 755 SCOTT CIRCLE, JBPH-HICKAM, HI 96853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD36551
TN
2083A0100X
Aerospace Medicine Physician
Primary
MD36551
TN
2083X0100X
Occupational Medicine Physician
MD36551
TN
Other
Enumeration date
09/26/2006
Last updated
08/02/2023
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