Charles W Pruitt, MD | |
100 N Medical Dr, Salt Lake City, UT 84113-1103 | |
(801) 662-1000 | |
Not Available |
Full Name | Charles W Pruitt |
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Gender | Male |
Speciality | Pediatrics - Pediatric Emergency Medicine |
Location | 100 N Medical Dr, Salt Lake City, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1962583757 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2080P0204X | Pediatrics - Pediatric Emergency Medicine | 6079976-1205 (Utah) | Primary |
Entity Name | University Of Utah Pediatric Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487018974 PECOS PAC ID: 0547552473 Enrollment ID: O20160713000371 |
Entity Name | University Of Utah Pediatric Acuity Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619325131 PECOS PAC ID: 6406148345 Enrollment ID: O20160713000869 |
Mailing Address | Practice Location Address |
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Charles W Pruitt, MD Po Box 581100, Salt Lake City, UT 84158-1100 Ph: (801) 213-3800 | Charles W Pruitt, MD 100 N Medical Dr, Salt Lake City, UT 84113-1103 Ph: (801) 662-1000 |
Kristina Mckinley, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: University Of Utah Hospital, 30 North 1900 East, Rm 1c412, Salt Lake City, UT 84132 Phone: 801-581-2401 | |
Dr. Zainab Kagen, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 S Chipeta Way Ste 14, Salt Lake City, UT 84108 Phone: 801-585-6943 | |
Kaitlin Carpenter, Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-1000 | |
Dr. Thomas Patrick Curtin, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 81 N Mario Capecchi Dr, Salt Lake City, UT 84113 Phone: 801-662-5700 | |
Anastasiya Mankouski, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5121 S Cottonwood St, Salt Lake City, UT 84107 Phone: 801-507-7000 | |
Joslynn Marie Hoburg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 295 S Chipeta Way Rm 2s010, Salt Lake City, UT 84108 Phone: 801-581-2121 | |
George W Delavan, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 44 N Mario Capecchi Dr, Salt Lake City, UT 84132 Phone: 801-584-8239 Fax: 801-584-8588 |