Individual
ALEXANDER PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
—
1091892
—
IA
01
—
1948
MIDLANDS CHOICE
NE
01
—
204803800
US DEPT OF LABOR
—
01
—
29770
SIOUX VALLEY HLTH PLNS
SD
01
—
36190
BLUE CROSS BLUE SHIELD
IA
05
—
7712720
—
SD
01
—
P00266324
RAILROAD MEDICARE
—
Enumeration date
08/25/2006
Last updated
07/25/2008
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