Organization
J LARRY PRITCHETT OD PC
Active
Parent organization
J LARRY PRITCHETT OD PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
J LARRY PRITCHETT OD PC
Authorized official
JAMES LARRY PRITCHETT OD (CEO)
(229) 995-2920
Entity
Organization
Contact information
Practice address
74 PEACHTREE STREET, CUTHBERT, GA 39840-5807
(229) 732-2552
Mailing address
279 PEARSON DR SW, DAWSON, GA 39842-1914
(229) 995-2920
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
—
000004199C
—
GA
01
—
52103165 002
BCBSGA
—
Enumeration date
01/10/2007
Last updated
12/16/2009
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