Individual
DR. PHILIP WORTHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(270) 412-8545
Mailing address
3603 INDIANA AVE, FORT CAMPBELL, KY 42223-5803
(270) 412-8545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
OK7327
OK
1223G0001X
General Practice Dentistry
7327
OK
Other
Enumeration date
08/12/2020
Last updated
03/17/2023
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