Provider Demographics
NPI:1033196969
Name:WORLEY, JOHN M (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:WORLEY
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6490 EXCELSIOR BLVD
Mailing Address - Street 2:STE 500
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-4705
Mailing Address - Country:US
Mailing Address - Phone:952-993-3551
Mailing Address - Fax:952-993-2701
Practice Address - Street 1:6490 EXCELSIOR BLVD
Practice Address - Street 2:STE E500
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-4705
Practice Address - Country:US
Practice Address - Phone:952-993-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2012-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN310602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology