Individual
JIMMY DANIEL PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-3580
Mailing address
5610 BETHELVIEW RD STE 500A, CUMMING, GA 30040-7530
(770) 205-2804
(770) 205-2854
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
029758
GA
207Q00000X
Family Medicine Physician
Primary
029758
GA
Other
Enumeration date
05/04/2006
Last updated
11/08/2023
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