Individual
DR. ROGER LEE WORTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 JEFFERSON ST STE 909, LAFAYETTE, LA 70501-6964
(337) 565-0200
(337) 565-0200
Mailing address
PO BOX 93243, LAFAYETTE, LA 70509-3243
(337) 565-0200
(337) 565-0200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
016463
LA
2084P0800X
Psychiatry Physician
D0064066
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07205
360 ALLIANCE - GILSBAR
—
01
—
23738
BLUE CROSS AND BLUE SHIELD OF LOUISIANA
LA
01
—
60054
AETNA (4433)
—
01
—
61101
HUMANA (5119)
KY
01
—
62308
CIGNA (4744)
TN
01
—
72128
VANTAGE HEALTH PLAN, INC, (5896)
LA
01
—
87726
UNITED HEALTHCARE (5867)
—
01
—
87843
CONSOLIDATED HEALTH PLANS (11405)
MA
01
—
TDDIR
TRICARE FOR LIFE (12098)
—
Enumeration date
09/14/2006
Last updated
09/09/2021
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