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Organization

ORTHOPAEDICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALEXANDER PRUITT MD (PRESIDENT)
(712) 580-2022
Entity
Organization

Contact information

Practice address
20 WEST 6TH ST, SUITE 1, SPENCER, IA 51301
(712) 580-2022
(712) 580-2024
Mailing address
20 WEST 6TH ST, SUITE 1, SPENCER, IA 51301
(712) 580-2022
(712) 580-2024

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
5151790001
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0180034
US DEPT OF LABOR & INDUST
05
0481754
IA
01
104435
HEALTH PARTNERS
01
204803800
US DEPT OF LABOR (ACS)
01
71119
WELLMARK SELECT
IA
01
DE0140
RAILROAD MEDICARE
IA
Enumeration date
01/31/2006
Last updated
06/26/2015
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