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Theodore Harmon Butcher

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3400 Spruce St, 4 Silverstein Building, Philadelphia, PA 19104-4206

(215) 662-2050

PECOS Enrollment

This provider is enrolled in PECOS as THEODORE BUTCHER.

Based on the most recent information from CMS, provider Theodore Harmon Butcher is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1679656359
Provider Type
Individual
Full Name
Butcher, Theodore Harmon
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
10/24/2006
Last Updated
2/11/2008

Contact Information

Practice Location

3400 Spruce St, 4 Silverstein Building, Philadelphia, PA 19104-4206

(215) 662-2050

Unlisted Fax

Mailing Location

3400 Spruce St, 4 Silverstein Building, Philadelphia, PA 19104-4206

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License MA00214L Pennsylvania

Theodore Harmon Butcher

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Averna, Tiffany Ann

Smith, Georgeine C

Lopez, Leah M

Paycardo, Anna

Jacob, Nancy Anne

Jacob, Anshu

Brookes, Peter James

Dymond, Daniel James

Chester, Shannon Mary

Drake, Colin A