MEDICARE: JOSEPH H WORISCHECK MD

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
1	174400000X	Specialist	20813	AZ

General Provider Information

NPI Number	:	1902870173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH H WORISCHECK MD

Provider Business Mailing Address
First Line	:	6007 E BASELINE RD STE 105
Second Line	:	#105
City	:	MESA
State	:	AZ
Zip	:	85206-4801
Country	:	US
Telephone Number	:	480-897-2727
Fax Number	:	480-892-3035

Provider Business Practice Location Address
First Line	:	6007 E BASELINE ROAD
Second Line	:	#105
City	:	GILBERT
State	:	AZ
Zip	:	85234-5044
Country	:	US
Telephone Number	:	480-897-2727
Fax Number	:	480-892-3035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	08/09/2013

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