Provider Demographics
NPI:1134580863
Name:KORTY, THEODORE THOMAS (DO)
Entity type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:THOMAS
Last Name:KORTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1449 KIMBER LN STE 102
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4067
Mailing Address - Country:US
Mailing Address - Phone:812-227-5524
Mailing Address - Fax:812-476-2616
Practice Address - Street 1:1449 KIMBER LN STE 102
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4067
Practice Address - Country:US
Practice Address - Phone:812-227-5524
Practice Address - Fax:812-476-2616
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1977208D00000X
IN02005894A207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice