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NPI Code Detail

MEDICARE: DR. MARCUS WILLIAM WORDEN DDS

MEDICARE:  DR. MARCUS WILLIAM WORDEN  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry36390TX

General Provider Information

NPI Number : 1033728530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCUS WILLIAM WORDEN DDS
Provider Business Mailing Address
First Line : 12922 COUNTY RD. 185
Second Line :
City : BULLARD
State : TX
Zip : 75757
Country : US
Telephone Number : 770-243-0070
Fax Number :
Provider Business Practice Location Address
First Line : 2336 ABERDEEN DR
Second Line :
City : TYLER
State : TX
Zip : 75703-1943
Country : US
Telephone Number : 903-581-1646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2020
Last Update Date : 07/30/2020

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Directions to “ DR. MARCUS WILLIAM WORDEN DDS” Practice Location

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