Healthcare Provider Details

I. General information

NPI: 1023655867
Provider Name (Legal Business Name): COMPREHENSIVE ACCIDENT AND INJURY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2019
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 BECKS WOODS DR
BEAR DE
19701-3833
US

IV. Provider business mailing address

131 BECKS WOODS DR
BEAR DE
19701-3833
US

V. Phone/Fax

Practice location:
  • Phone: 302-595-2584
  • Fax: 302-595-3142
Mailing address:
  • Phone: 302-303-7740
  • Fax: 302-595-3142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JACK EARL NORSWORTHY JR.
Title or Position: OWNER
Credential: D.C.
Phone: 302-595-2584