Individual
DR. KEVIN L PRITCHETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 SPRINGFIELD CT, O FALLON, IL 62269-2495
(618) 632-3565
(618) 632-7693
Mailing address
100 SPRINGFIELD CT, O FALLON, IL 62269-2495
(618) 632-3565
(618) 632-7693
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036072222
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036072222
—
IL
01
—
P00349295
MEDICARE RAILROAD
IL
Enumeration date
07/20/2005
Last updated
12/28/2021
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