Organization
MAGEE AFTER HOURS CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES PRUITT M.D. (DOCTOR)
(601) 849-1230
Entity
Organization
Contact information
Practice address
376 SIMPSON HIGHWAY 149 # A, MAGEE, MS 39111-3409
(601) 849-1230
(601) 849-1890
Mailing address
376 SIMPSON HIGHWAY 149 # A, MAGEE, MS 39111-3409
(601) 849-1230
(601) 849-1890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA024
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04874839
—
MS
Enumeration date
05/16/2007
Last updated
08/22/2020
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