Organization
KEVIN L PRITCHETT M.D PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L PRITCHETT M.D. (PRESIDENT)
(618) 632-3565
Entity
Organization
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
01
—
214065
MEDICARE GROUP NUMBER
IL
01
—
P00349295
MEDICARE RAILROAD
IL
Enumeration date
10/02/2006
Last updated
03/09/2009
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