Provider Demographics
NPI:1710988902
Name:PRITCHARD, TYRUS ANDREW (MD)
Entity Type:Individual
Prefix:DR
First Name:TYRUS
Middle Name:ANDREW
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:646 COX CREEK PKWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-1105
Mailing Address - Country:US
Mailing Address - Phone:256-764-9994
Mailing Address - Fax:256-246-0035
Practice Address - Street 1:646 COX CREEK PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1105
Practice Address - Country:US
Practice Address - Phone:256-764-9994
Practice Address - Fax:256-246-0035
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2012-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL9036208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51507927OtherBCBS
AL340020160Medicare PIN
ALC76490Medicare UPIN
AL51507927OtherBCBS