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NPI Code Detail

MEDICARE: BRYAN PRUITT MD

MEDICARE:   BRYAN  PRUITT  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology PhysicianAL21218AL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160007725OTHERALRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
251018483OTHERALBLUE CROSS AND BLUE SHIEL
37412000OTHERALUNITED HEALTH CARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548375702
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN PRUITT MD
Provider Business Mailing Address
First Line : 48 MEDICAL PARK DR E
Second Line : SUITE 355
City : BIRMINGHAM
State : AL
Zip : 35235-3400
Country : US
Telephone Number : 205-838-3036
Fax Number : 205-838-5832
Provider Business Practice Location Address
First Line : 2006 BROOKWOOD MED CTR DR STE 600
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-6885
Country : US
Telephone Number : 205-838-3036
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 06/24/2026

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Directions to “ BRYAN PRUITT MD” Practice Location

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