Individual
CANDACE WORSHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1924 30TH AVE, GULFPORT, MS 39501-4534
(228) 863-7117
Mailing address
1924 30TH AVE, GULFPORT, MS 39501-4534
(228) 863-7117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21172
MS
Other
Enumeration date
07/11/2007
Last updated
08/04/2010
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