Provider Demographics
NPI:1306559679
Name:PRITCHETT, THOMAS
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:PRITCHETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 TRENT RD STE 9
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-2220
Mailing Address - Country:US
Mailing Address - Phone:252-514-2155
Mailing Address - Fax:252-514-0303
Practice Address - Street 1:3515 TRENT RD STE 9
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2220
Practice Address - Country:US
Practice Address - Phone:252-514-2155
Practice Address - Fax:252-514-0303
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-03
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-13826363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant