Healthcare Provider Details

I. General information

NPI: 1295734606
Provider Name (Legal Business Name): CARI M. WORLEY HENRY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3217 S PROVIDENCE RD
COLUMBIA MO
65203-3639
US

IV. Provider business mailing address

PO BOX 7687
COLUMBIA MO
65205-7687
US

V. Phone/Fax

Practice location:
  • Phone: 573-884-7733
  • Fax: 573-884-5559
Mailing address:
  • Phone: 573-882-2259
  • Fax: 573-884-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2002014089
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: