Liese Pruitt, MD in Salt Lake City, UT - Medicare Surgery

Liese Pruitt, MD is a medicare enrolled "Surgery" physician in Salt Lake City, Utah. Her current practice location is 30 N 1900 E Rm 3b324, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 581-6803.

Liese Pruitt is licensed to practice in Utah (license number 10108478-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265827083.

Contact Information

	Liese Pruitt, MD
	30 N 1900 E Rm 3b324, Salt Lake City, UT 84132-0002
	(801) 581-6803
	(801) 581-7122

Physician's Profile

Full Name	Liese Pruitt
Gender	Female
Speciality	Surgery
Location	30 N 1900 E Rm 3b324, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1265827083
Provider Enumeration Date: 03/30/2015
Last Update Date: 10/11/2016

Medicare PECOS Information:

PECOS PAC ID: 9436438991
Enrollment ID: I20161128001808

Medical Identifiers

Medical identifiers for Liese Pruitt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1265827083	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	10108478-1205 (Utah)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Liese Pruitt is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Liese Pruitt, MD 30 N 1900 E Rm 3b324, Salt Lake City, UT 84132-0002 Ph: (801) 581-6803	Liese Pruitt, MD 30 N 1900 E Rm 3b324, Salt Lake City, UT 84132-0002 Ph: (801) 581-6803

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Surgery Doctors in Salt Lake City, UT

Dr. Gregory Lawrence Livers, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 129 F St, Salt Lake City, UT 84103 Phone: 801-364-3091
Dr. Melanie Ann Dance, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1250 E 3900 S, Salt Lake City, UT 84124 Phone: 801-265-2000
Alexander Schurman, Surgery Medicare: Not Enrolled in Medicare Practice Location: 30 N Mario Capecchi Dr Rm 4s100, Salt Lake City, UT 84112 Phone: 801-581-2121
Kaohinani Joseph Longwolf, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 30 N 1900 E Rm 3c344, Salt Lake City, UT 84132 Phone: 801-213-2598
Marisol Z. Monzon, MD Surgery Medicare: Medicare Enrolled Practice Location: 30 N Mario Capecchi Dr Rm 4s100, Salt Lake City, UT 84112 Phone: 801-581-2121
Dr. Charles David Richards, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1391 E Farm Hill Dr, Salt Lake City, UT 84117 Phone: 801-272-6859
Dr. Teresa Reading, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 324 10th Ave, #100, Salt Lake City, UT 84103 Phone: 801-408-7660 Fax: 801-408-7650

Liese Pruitt, MD - Medicare Surgery in Salt Lake City, UT