Pruitt, Jerry L

Pruitt, Jerry L is an individual health care provider with primary practice located at 245 11Th Ave Ne , Hickory NC 28601-3835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Pruitt, Jerry L can be contacted via phone (828) 328-3500.

Contact Information

Primary practice address
245 11Th Ave Ne Hickory NC 28601-3835
Phone: (828) 328-3500
Fax: (828) 328-8777
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 17415 North Carolina

Profile Details

NPI number 1124078274
LBN Legal business name Pruitt, Jerry L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Jun 23rd, 2020 - about 4 years ago

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 1124078274 NPPES
North Carolina Other 69390 BCBS PROVIDER NUMBER
North Carolina MEDICAID 8909390 BCBS PROVIDER NUMBER

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