Provider Demographics
NPI:1588718282
Name:PRITCHARD, J. SCOTT (DO)
Entity type:Individual
Prefix:
First Name:J.
Middle Name:SCOTT
Last Name:PRITCHARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1374 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:SILVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97381-2427
Mailing Address - Country:US
Mailing Address - Phone:503-874-9985
Mailing Address - Fax:
Practice Address - Street 1:3150 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1350
Practice Address - Country:US
Practice Address - Phone:503-986-4962
Practice Address - Fax:800-574-2193
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO13835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine