Provider Demographics
NPI:1598393159
Name:PITTMAN, BRUCE CARLTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:CARLTON
Last Name:PITTMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 LORNA RD APT 1824
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5436
Mailing Address - Country:US
Mailing Address - Phone:336-681-3256
Mailing Address - Fax:
Practice Address - Street 1:3101 LORNA RD APT 1824
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5436
Practice Address - Country:US
Practice Address - Phone:336-681-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program