Pruitt, Jamon R

Pruitt, Jamon R is an individual health care provider with primary practice located at 2900 Medical Center Pkwy Suite 240B, Bentonville AR 72712-3204. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Pruitt, Jamon R can be contacted via phone (479) 553-2200.

Contact Information

Primary practice address
2900 Medical Center Pkwy Suite 240B Bentonville AR 72712-3204
Phone: (479) 553-2200
Fax: (479) 553-2909
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X C8298 Arkansas

Profile Details

NPI number 1174567812
LBN Legal business name Pruitt, Jamon R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Mar 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174567812 NPPES
Arkansas Other 180380000 QUAL CHOICE
Arkansas Other 5005701 QUAL CHOICE
Arkansas MEDICAID 204813307 QUAL CHOICE
Arkansas MEDICAID 135004001 QUAL CHOICE
Arkansas Other 1900365 QUAL CHOICE
Arkansas MEDICAID 100077970A QUAL CHOICE
Arkansas Other C8298 QUAL CHOICE

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