| John B. Theobalds & Associate Inc | |
|
3636 16th St Nw Suite Ag69 Washington DC 20010-1146 | |
| (202) 667-8701 | |
| (202) 234-9218 |
| Full Name | John B. Theobalds & Associate Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 3636 16th St Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | John B Theobalds (PRESIDENT) |
| Authorized Official Contact | 2026678701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John B. Theobalds & Associate Inc 3636 16th St Nw Suite Ag69 Washington DC 20010-1146 Ph: (202) 667-8701 | John B. Theobalds & Associate Inc 3636 16th St Nw Suite Ag69 Washington DC 20010-1146 Ph: (202) 667-8701 |
| NPI Number | 1548572985 |
|---|---|
| Provider Enumeration Date | 07/13/2010 |
| Last Update Date | 07/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548572985 | NPI | - | NPPES |
| 025405900 | Medicaid | DC | |
| 777791400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD11684 (District Of Columbia) | Primary |
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