Organization
ORTHOPAEDICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER PRUITT MD (PRESIDENT)
(712) 580-2022
Entity
Organization
Contact information
Practice address
20 W 6TH ST, SPENCER, IA 51301-3901
(712) 580-2022
(712) 580-2024
Mailing address
20 W 6TH ST, SPENCER, IA 51301-3901
(712) 580-2022
(712) 580-2024
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
29040
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0481754
—
IA
01
—
1477639235
DMERC REGION D NPI
IA
01
—
1861463473
CLINIC NPI
—
Enumeration date
10/27/2006
Last updated
11/06/2007
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