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General NPI Number Information
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NPI Number | 1477441681
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Entity Type | Organization
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Legal Business Name | WORTHAM & FLORENCE ENTERPRISES
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 01/04/2026
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Provider Practice Location Address
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Address Line | 113 CLARETT CT
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City | UNION
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State | OH
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Zip | 45322-3545
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Country | US
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Telephone | 937-321-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 6545 MARKET AVE N STE 100
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City | CANTON
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State | OH
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Zip | 44721-2430
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Country | US
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Telephone | 937-321-0002
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MR. ROOSEVELT H WORTHAM-FLORENCE
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Credential | NP
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Telephone | 937-321-0002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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