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NPI Code Detail

MEDICARE: ROSS A WORTHINGTON MD

MEDICARE: ROSS A WORTHINGTON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician45231WI

General Provider Information

NPI Number : 1023043429
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSS A WORTHINGTON MD
Provider Business Mailing Address
First Line : 8901 W LINCOLN AVE
Second Line :
City : WEST ALLIS
State : WI
Zip : 53227-2477
Country : US
Telephone Number : 414-328-7950
Fax Number : 414-328-8505
Provider Business Practice Location Address
First Line : 2629 N 7TH ST
Second Line :
City : SHEBOYGAN
State : WI
Zip : 53083-4932
Country : US
Telephone Number : 920-451-5542
Fax Number : 920-451-5544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 12/09/2021

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Directions to “ ROSS A WORTHINGTON MD” Practice Location

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