MEDICARE: CALVIN JAMES WORRELL PA

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
1	363A00000X	Physician Assistant	10993	AZ

General Provider Information

NPI Number	:	1053188045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALVIN JAMES WORRELL PA

Provider Business Mailing Address
First Line	:	2842 N MELPOMENE DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85749-9768
Country	:	US
Telephone Number	:	928-856-1862
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 W ORANGE GROVE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-1139
Country	:	US
Telephone Number	:	480-443-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	04/15/2026

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