Organization
J LARRY PRITCHETT O D P C
Active
Parent organization
J LARRY PRITCHETT O D P C
Organization subpart
Yes
Provider details
NPI number
Legal business name
J LARRY PRITCHETT O D P C
Authorized official
JAMES LARRY PRITCHETT O.D. (CEO)
(229) 995-2920
Entity
Organization
Contact information
Practice address
162 E BROAD ST, CAMILLA, GA 31730-1841
(229) 336-8991
(229) 336-0141
Mailing address
279 PEARSON DR SW, DAWSON, GA 39842-1914
(229) 995-2920
(229) 995-5034
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000689
GA
332H00000X
Eyewear Supplier
OPT000689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000004199B
—
GA
01
—
52103165 001
BCBSGA
—
Enumeration date
01/10/2007
Last updated
01/21/2010
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