# JOHN B. THEOBALDS & ASSOCIATE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548572985
- **Authorized official:** MR. JOHN B THEOBALDS M.D. (PRESIDENT)
- **Authorized official phone:** (202) 667-8701

## Contact information

- **Practice address:** 3636 16TH ST NW, SUITE AG69, WASHINGTON, DC 20010-1146
- **Practice address phone:** (202) 667-8701
- **Practice address fax:** (202) 234-9218
- **Mailing address:** 3636 16TH ST NW, SUITE AG69, WASHINGTON, DC 20010-1146
- **Mailing address phone:** (202) 667-8701
- **Mailing address fax:** (202) 234-9218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD11684 | DC | Yes |

## Other

- **Enumeration date:** 07/13/2010
- **Last updated:** 07/13/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 025405900 | — | DC |
| 05 | — | 777791400 | — | MD |