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General NPI Number Information
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NPI Number | 1952699894
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Entity Type | Individual
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Provider Name | JONATHAN WORKMAN DO
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Gender | Male
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Dates
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Enumeration Date | 07/13/2011
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 3098 OAK GROVE RD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-8938
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Country | US
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Telephone | 573-778-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 3098 OAK GROVE RD
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City | POPLAR BLUFF
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State | MO
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Zip | 63901-8938
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Country | US
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Telephone | 573-778-2600
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 2021048127
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2021048127
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License Number State | MO
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