Individual
PATCHOUCO THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1924 ALCOA HWY # U-67, KNOXVILLE, TN 37920-1511
(865) 305-9350
(865) 305-8942
Mailing address
10300 SW 216TH ST, CUTLER BAY, FL 33190-1003
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
66626
TN
207Q00000X
Family Medicine Physician
Primary
350083
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2019
Last updated
12/10/2025
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