Individual
DR. DAVID EDWIN PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
1455 HIGDON FERRY RD, HOT SPRINGS, AR 71913-6419
(501) 622-2100
(501) 622-2214
Mailing address
PO BOX 22148, HOT SPRINGS, AR 71903-2148
(501) 622-1913
(501) 622-4676
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E3086
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5L933
BLUE CROSS PROV #
AR
01
—
7596359
AETNA ID #
—
Enumeration date
07/31/2006
Last updated
07/08/2007
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