Provider Demographics
NPI:1619912508
Name:PRITCHETT, EVAN F (OD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:F
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:5961 LOS ALTOS PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-2500
Mailing Address - Country:US
Mailing Address - Phone:775-359-2020
Mailing Address - Fax:775-359-2676
Practice Address - Street 1:5961 LOS ALTOS PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-2500
Practice Address - Country:US
Practice Address - Phone:775-359-2020
Practice Address - Fax:775-359-2676
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV37416Medicare PIN
NV4682730001Medicare NSC
NVV37415Medicare PIN
U70913Medicare UPIN