Provider Demographics
NPI:1326353061
Name:PRITCHETT EYE CARE PC
Entity type:Organization
Organization Name:PRITCHETT EYE CARE PC
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 1:831 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2501
Practice Address - Country:US
Practice Address - Phone:775-746-2020
Practice Address - Fax:775-746-2022
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
NV1326353061Medicaid
NV1326353061Medicaid