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General NPI Number Information
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NPI Number | 1033121637
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Entity Type | Individual
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Provider Name | JAMES M HOUSEWORTH DDS
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4 S HOSPITAL DR
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City | MURPHYSBORO
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State | IL
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Zip | 62966-3333
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Country | US
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Telephone | 618-684-2321
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Fax | 618-684-2417
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Provider Business Mailing Address
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Address Line | 805 REBEKAH LN
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City | CARTERVILLE
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State | IL
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Zip | 62918-1011
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Country | US
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Telephone | 618-684-2321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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