Individual
JOHN C. PRITCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 N CLINTON ST, FORT WAYNE, IN 46825-5886
(260) 484-8551
(260) 482-5060
Mailing address
5052 N CLINTON ST, FORT WAYNE, IN 46825-5822
(260) 484-8551
(260) 482-5060
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01038267A
IN
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01038267A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058940O
MEDICARE PTAN
IN
05
—
0926029
—
OH
05
—
100322960
—
IN
01
—
200016881
RAIL ROAD MEDICARE
IN
Enumeration date
08/04/2005
Last updated
10/22/2018
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