Healthcare Provider Details
I. General information
NPI: 1023294030
Provider Name (Legal Business Name): JAMES LEONARD WORKMAN JR. PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2008
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1015 UNITY RD
CROSSETT AR
71635-9443
US
IV. Provider business mailing address
PO BOX 9178
RUSSELLVILLE AR
72811-9178
US
V. Phone/Fax
- Phone: 855-498-6768
- Fax: 479-968-1673
- Phone: 855-498-6768
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
LEONARD
WORKMAN
JR.
Title or Position: STAFF
Credential: MD
Phone: 501-912-0598