MEDICARE: DR. MARK B WORKMAN 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	207RC0000X	Cardiovascular Disease Physician	35-047833	OH
2	207RC0000X	Cardiovascular Disease Physician	18687	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00893682	OTHER	KY	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	611300608065	OTHER	OH	CARESOURCE

General Provider Information

NPI Number	:	1437141876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK B WORKMAN MD

Provider Business Mailing Address
First Line	:	1500 JAMES SIMPSON JR WAY
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-0801
Country	:	US
Telephone Number	:	859-655-9500
Fax Number	:	859-655-3077

Provider Business Practice Location Address
First Line	:	1500 JAMES SIMPSON JR WAY
Second Line	:
City	:	COVINGTON
State	:	KY
Zip	:	41011-0801
Country	:	US
Telephone Number	:	859-655-9500
Fax Number	:	859-655-3077

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	02/15/2012

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Directions to “ DR. MARK B WORKMAN MD” Practice Location

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