Individual
JEFFREY THOMAS TRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3998 RED LION RD, SUITE 304, PHILADELPHIA, PA 19114-1445
(215) 612-4060
(215) 612-2630
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-6335
(215) 807-8000
(215) 612-2630
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD441537
PA
208VP0000X
Pain Medicine Physician
Primary
MD441537
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025978590001
—
PA
01
—
2629431
HIGHMARK BLUE SHIELD
PA
01
—
3846091000
KEYSTONE IBC
PA
Enumeration date
11/04/2007
Last updated
10/07/2011
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