=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780616961
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD HUNTER WORKMAN JR. MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 02/03/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2400 RUSSELLVILLE RD
-----------------------------------------------------
City | HOPKINSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42241-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-889-6025
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2400 RUSSELLVILLE RD P.O. BOX 2200
-----------------------------------------------------
City | HOPKINSVILLE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42241-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-889-6025
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 43681
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------