Provider Demographics
NPI:1073945259
Name:PRITTS, ERIC L (PA-C)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:L
Last Name:PRITTS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 WAYLAND SMITH DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2677
Mailing Address - Country:US
Mailing Address - Phone:724-437-8200
Mailing Address - Fax:724-437-6673
Practice Address - Street 1:150 WAYLAND SMITH DR
Practice Address - Street 2:SUITE A
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-2677
Practice Address - Country:US
Practice Address - Phone:724-437-8200
Practice Address - Fax:724-437-6673
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003089363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOA003089OtherLICENSE
PA299572SVTMedicare PIN
299573WH2Medicare PIN