MEDICARE: DR. RODNEY L WORTHEN II 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
1	208800000X	Urology Physician	13665	OK

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	340017066	OTHER	OK	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336141696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY L WORTHEN II MD

Provider Business Mailing Address
First Line	:	615 E. OKLAHOMA AVE
Second Line	:	STE 202
City	:	ENID
State	:	OK
Zip	:	73701-5952
Country	:	US
Telephone Number	:	580-233-3230
Fax Number	:	580-233-0698

Provider Business Practice Location Address
First Line	:	615 E. OKLAHOMA AVE.
Second Line	:	STE 202
City	:	ENID
State	:	OK
Zip	:	73701-5952
Country	:	US
Telephone Number	:	580-233-3230
Fax Number	:	580-233-0698

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	08/26/2014

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