Josoph J. Theodore, M.D.
Individual provider Active NPI Internal Medicine Physician · Chattahoochee, FL
NPI 1235348558 · NPPES record last updated Nov 12, 2009
Key facts
- NPI
- 1235348558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- ME0049172 (FL)
- Practice address
- 100 N Main St
Chattahoochee, FL 32324-1107 - Phone
- (850) 663-7661
- Fax
- (850) 663-7113
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0049172 | FL | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME0049172 | FL | Yes |
Addresses
Primary practice location
100 N Main St
Chattahoochee, FL 32324-1107
Mailing address
100 North Main Street
Chattahoochee, FL 33224-1000
Phone (850) 663-7661
Other providers in Chattahoochee, FL
- Bailey Clinton Singletary
- Nicholas Spragg
- Amy Lynn Sterrett
- Azaia Stubbs
- Uldarico Badiongan Tan
- John G Tugwell
- Scarlett Beverly Varn
- Cuong Quoc Vu
- Glen Harold Watson Jr.
- Lauren Genna Wood
All providers in Chattahoochee, FL · Internal Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.