Individual
DR. PITCHAR THEERATHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 MED TECH PKWY STE 240, JOHNSON CITY, TN 37604-2641
(423) 794-5520
(423) 282-6940
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 794-5520
(423) 282-6940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26545
SC
207R00000X
Internal Medicine Physician
Primary
35127
TN
208M00000X
Hospitalist Physician
35127
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279422500
—
FL
05
—
3877775
—
TN
01
—
562173631
TAX ID
SC
Enumeration date
04/07/2006
Last updated
02/24/2025
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