MEDICARE: PRITCHETT EYE CARE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	NV0341	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588061675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRITCHETT EYE CARE PC

Provider Business Mailing Address
First Line	:	5961 S LOS ALTOS PKWY
Second Line	:	STE101
City	:	SPARKS
State	:	NV
Zip	:	89436-2501
Country	:	US
Telephone Number	:	775-359-2020
Fax Number	:	775-359-2676

Provider Business Practice Location Address
First Line	:	1095 N HILLS BLVD
Second Line	:	STE B
City	:	RENO
State	:	NV
Zip	:	89506-8691
Country	:	US
Telephone Number	:	775-677-1020
Fax Number	:	775-677-0817

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONATHAN MARK CHRISTIANSEN
Credential	:	OD
Telephone Number	:	714-356-8451

Provider Enumeration Date	:	12/04/2014
Last Update Date	:	08/01/2024

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Directions to “PRITCHETT EYE CARE PC ” Practice Location

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