Josoph J. Theodore, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0049172 Issued in FL

Practice address

100 N Main St
Chattahoochee, FL 32324-1107

Phone

(850) 663-7661

Fax

(850) 663-7113

NPI assigned

May 22, 2007

Last updated

Nov 12, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1235348558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTH MAIN STREET",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "332241000",
            "telephone_number": "850-663-7661",
            "fax_number": "850-663-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MAIN ST",
            "city": "CHATTAHOOCHEE",
            "state": "FL",
            "postal_code": "323241107",
            "telephone_number": "850-663-7661",
            "fax_number": "850-663-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORE",
        "first_name": "JOSOPH",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0049172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Spragg, BCBA
• Amy Lynn Sterrett
• Azaia Stubbs, APRN
• Uldarico Badiongan Tan, M.D.
• Lacy Tetstone
• John G Tugwell, OD
• Scarlett Beverly Varn, A.R.N.P.
• Cuong Quoc Vu, M.D.
• Glen Harold Watson Jr., PH.D.
• Lauren Genna Wood, APRN

• Internal Medicine Physician in Chattahoochee, FL
• Providers in Chattahoochee, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.