Provider Demographics
NPI:1063727709
Name:PRITCHETT EYE CARE
Entity type:Organization
Organization Name:PRITCHETT EYE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-356-8451
Mailing Address - Street 1:5961 LOS ALTOS PKWY
Mailing Address - Street 2:STE 101
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-2500
Mailing Address - Country:US
Mailing Address - Phone:775-359-2020
Mailing Address - Fax:775-359-2676
Practice Address - Street 1:1701 COUNTY RD
Practice Address - Street 2:STE Q
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4464
Practice Address - Country:US
Practice Address - Phone:775-782-3937
Practice Address - Fax:775-783-4288
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRITCHETT EYE CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-17
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1063727709Medicaid
NVV37415Medicare UPIN
NV4682730008Medicare NSC