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Individual

KENT TILIS WORTHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
26700 S US HIGHWAY 85, AZ CORRECTIONS LEWIS, BUCKEYE, AZ 85326-5024
(623) 386-6160
Mailing address
26700 S US HIGHWAY 85, AZ CORRECTIONS LEWIS, BUCKEYE, AZ 85326-5024
(623) 386-6160

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
005741
AZ
2084P0800X
Psychiatry Physician
4954099-1204
UT

Other

Enumeration date
08/14/2006
Last updated
01/13/2012
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