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Individual

DR. PATRICK THEODORE CODE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2655 SISKIYOU BLVD, MEDFORD, OR 97504-8125
(541) 773-3338
(541) 772-9526
Mailing address
2655 SISKIYOU BLVD, MEDFORD, OR 97504-8125
(541) 773-3338
(541) 772-9526

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DP002200
OR
213EP1101X
Primary Podiatric Medicine Podiatrist
DP002200
OR
213ES0103X
Foot & Ankle Surgery Podiatrist
DP002200
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
034947
OR
Enumeration date
01/24/2007
Last updated
09/11/2025
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