Individual
JOHN EVERETT WORTHINGTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-7899
(864) 455-5474
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
17963
SC
207P00000X
Emergency Medicine Physician
2015-02379
NC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
017963
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179639
—
SC
01
—
NCS025A194
MEDICARE PTAN
NC
Enumeration date
03/14/2006
Last updated
05/26/2021
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