Individual
DR. CHARLES PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 SIMPSON HIGHWAY 149, SUITE300, MAGEE, MS 39111-3841
(601) 849-1230
(601) 849-1890
Mailing address
360 SIMPSON HWY 149, SUITE300, MAGEE, MS 39111-3409
(601) 849-1230
(601) 849-1890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
06021
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123423
—
MS
Enumeration date
09/28/2006
Last updated
03/07/2023
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