MEDICARE: HAROLD RAY PRITCHETT III MD

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	208M00000X	Hospitalist Physician	E-15911	AR
2	207Q00000X	Family Medicine Physician	102871	GA

General Provider Information

NPI Number	:	1023646734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD RAY PRITCHETT III MD

Provider Business Mailing Address
First Line	:	225 E WASHINGTON AVE
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401-3111
Country	:	US
Telephone Number	:	870-207-4100
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 RIVER RD STE 101
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-3353
Country	:	US
Telephone Number	:	706-494-0694
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2020
Last Update Date	:	03/24/2025

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