Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 17690 | AZ |
NPI | 1023014453 |
---|---|
Provider Name | Dr. Delwyn J Worthington |
First Address | Salt Lake City, UT 84127-1429 |
Second Address | Phoenix, AZ 85018-7227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2005 |
Last Update Date | 29/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276578 | (05) | AZ |