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General NPI Number Information
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NPI Number | 1922080993
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Entity Type | Individual
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Provider Name | CLARENCE MACDONALD WORLEY MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1732 W BROADWAY AVE
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City | MARYVILLE
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State | TN
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Zip | 37801-5510
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Country | US
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Telephone | 678-524-5077
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Fax |
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Provider Business Mailing Address
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Address Line | 156 FENCERAIL GAP
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City | WALLAND
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State | TN
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Zip | 37886-2510
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Country | US
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Telephone | 678-524-5077
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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 | 125Q00000X
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Taxonomy Name | Oral Medicine Dentistry
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License Number | 9764
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 51786
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License Number State | TN
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