1073518577 Dr. David A Theodoro, M.D.
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Reactivated
Basic Information
- Full Name
- Dr. David A Theodoro, M.D.
- Gender
- Male
- Enumeration Date
- June 20, 2005
- Last Update
- August 27, 2020
- Deactivation Date
- March 20, 2006
- Reactivation Date
- April 5, 2006
Practice Location
- Address
- 12255 DE PAUL DR NORTH BLDG
STE 260
BRIDGETON, MO 63044 - Phone
- (314) 647-8269
- Fax
- (314) 646-1700
Mailing Address
- Address
- PO BOX 23666
JACKSON, MS 392253666 - Phone
- (601) 200-2780
- Fax
- (601) 200-2788
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 118293 | MO | No |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 036095641 | IL | No |
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 28104 | MS | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036056372 | 01 | IL | SUBSTANCE CONTROL |
| 0360957641 | 05 | MO | N/A |
| 1102596 | 01 | MO | BNDD |
| 036056372 | 01 | IL | LICENSE |
| 118293 | 01 | MO | LICENSE |
| 036095641 | 05 | IL | N/A |
Additional Practice Locations
970 Lakeland Dr Ste 61
Jackson, MS 392164634
Jackson, MS 392164634
Phone: (601) 200-2780
Fax: (601) 200-2788
Frequently Asked Questions
What is Dr. David A Theodoro, M.D.'s NPI number?
Dr. David A Theodoro, M.D.'s NPI number is 1073518577.
Which doctor has NPI number 1073518577?
The doctor with NPI number 1073518577 is Dr. David A Theodoro, M.D..
What is Dr. David A Theodoro, M.D.'s practice address?
Dr. David A Theodoro, M.D.'s practice address is 12255 DE PAUL DR NORTH BLDG, STE 260, BRIDGETON, MO, 63044.
Which doctor practices at 12255 DE PAUL DR NORTH BLDG, STE 260, BRIDGETON, MO, 63044?
Dr. David A Theodoro, M.D. practices at 12255 DE PAUL DR NORTH BLDG, STE 260, BRIDGETON, MO, 63044.
What is Dr. David A Theodoro, M.D.'s mailing address?
Dr. David A Theodoro, M.D.'s mailing address is PO BOX 23666, JACKSON, MS, 392253666.
What is Dr. David A Theodoro, M.D.'s phone number?
Dr. David A Theodoro, M.D.'s phone number is (314) 647-8269.
Who is (314) 647-8269?
(314) 647-8269 is the phone number for Dr. David A Theodoro, M.D..
What is Dr. David A Theodoro, M.D.'s specialty?
Dr. David A Theodoro, M.D.'s specialty is Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician.
What type of doctor is Dr. David A Theodoro, M.D.?
Dr. David A Theodoro, M.D. is a Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician.
Is Dr. David A Theodoro, M.D. a Thoracic Surgery (Cardiothoracic Vascular Surgery)?
Yes, Dr. David A Theodoro, M.D. is a Thoracic Surgery (Cardiothoracic Vascular Surgery).
Is Dr. David A Theodoro, M.D. still practicing?
Yes, Dr. David A Theodoro, M.D. has reactivated their practice and is currently practicing.
Is Dr. David A Theodoro, M.D. accepting new patients?
Dr. David A Theodoro, M.D. may be accepting new patients. Please call their office at (314) 647-8269 to inquire about availability.
Is NPI 1073518577 still active?
Yes, NPI 1073518577 has been reactivated and is currently active.
Where does Dr. David A Theodoro, M.D. practice?
Dr. David A Theodoro, M.D. practices in BRIDGETON, MO.
Is Dr. David A Theodoro, M.D. a male or female doctor?
Dr. David A Theodoro, M.D. is a male doctor.