Provider Demographics
NPI:1275843468
Name:PAUL E PRITCHETT SR MD LLC
Entity Type:Organization
Organization Name:PAUL E PRITCHETT SR MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDDIE
Authorized Official - Last Name:PRITCHETT,
Authorized Official - Suffix:SR
Authorized Official - Credentials:M D
Authorized Official - Phone:240-349-2315
Mailing Address - Street 1:118 LAGRANGE AVE
Mailing Address - Street 2:PO BOX 1317
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646
Mailing Address - Country:US
Mailing Address - Phone:240-349-2315
Mailing Address - Fax:301-934-6224
Practice Address - Street 1:118 LAGRANGE AVE
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646
Practice Address - Country:US
Practice Address - Phone:240-349-2315
Practice Address - Fax:301-934-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty