Individual
RUSSELL FRANKLIN PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4900 IVEY RD NW BLDG 1000, SUITE 1025, ACWORTH, GA 30101-4001
(770) 917-9557
(770) 917-9558
Mailing address
4900 IVEY RD NW BLDG 1000, SUITE 1025, ACWORTH, GA 30101-4001
(770) 917-9557
(770) 917-9558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
041931
GA
208600000X
Surgery Physician
Primary
041931
GA
Other
Enumeration date
10/18/2006
Last updated
03/30/2016
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