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Individual

MR. RICHARD A PRIVRATSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
446 3RD AVE W, DICKINSON, ND 58601-4940
(701) 225-2020
(701) 483-5879
Mailing address
PO BOX 967, DICKINSON, ND 58602-0967
(701) 225-2020
(701) 483-5879

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
334
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410019689
RAILROAD MEDICARE
05
60019
ND
01
800334
BLUE CROSS VISION
ND
Enumeration date
01/30/2006
Last updated
06/29/2010
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