Provider Demographics
NPI:1659450096
Name:TOCHEV, TIHOMIR IVANOV (MD)
Entity Type:Individual
Prefix:DR
First Name:TIHOMIR
Middle Name:IVANOV
Last Name:TOCHEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 STEELE CREEK PARK RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-7206
Mailing Address - Country:US
Mailing Address - Phone:423-652-0554
Mailing Address - Fax:
Practice Address - Street 1:1501 E STONE DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4132
Practice Address - Country:US
Practice Address - Phone:423-378-9006
Practice Address - Fax:423-378-6223
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000030081207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3819576Medicaid
G64317Medicare UPIN
TN3819576Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER