MEDICARE: DR. ELEANOR KAREN PRUITT DMD

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
1	1223G0001X	General Practice Dentistry	2295-86	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64-0903196	OTHER	MS	TAX ID#

General Provider Information

NPI Number	:	1598876161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELEANOR KAREN PRUITT DMD

Provider Business Mailing Address
First Line	:	115 BRIDGETON PLZ
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39272-8711
Country	:	US
Telephone Number	:	601-372-2351
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 BRIDGETON PLZ
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39272-8711
Country	:	US
Telephone Number	:	601-372-2351
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	12/02/2010

Similar Medicare Providers

1952695413 — BLADIMIR CORTEZ
Practice Location Address:

8711 35TH AVE APT 2L
JACKSON HTS, NY
11372-5632

Practice Phone: 347-524-9396
Practice Fax:

1689896250 — SOUTHERN FAMILY DENTISTRY
Practice Location Address:

115 BRIDGETON PLZ
BYRAM, MS
39272-8711

Practice Phone: 601-373-4500
Practice Fax: 601-373-4503

1578032132 — LD-BYRAM, LLC
Practice Location Address:

115 BRIDGETON PLZ
BYRAM, MS
39272-8711

Practice Phone: 601-373-4500
Practice Fax: 662-586-2995

1164499190 — THOMAS P FORKS DO
Practice Location Address:

7275 S SIWELL RD
JACKSON, MS
39272-9776

Practice Phone: 601-373-7722
Practice Fax: 601-373-7378

1902874571 — WILLIAM KEITH HARRIS MD
Practice Location Address:

7275 S SIWELL RD
JACKSON, MS
39272-9776

Practice Phone: 601-373-7722
Practice Fax: 601-373-7378

1407825987 — ROBERT JUDSON WILLIAMS ANP
Practice Location Address:

7275 S SIWELL RD
JACKSON, MS
39272-9776

Practice Phone: 601-373-7722
Practice Fax: 601-373-7378

Directions to “ DR. ELEANOR KAREN PRUITT DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.