Provider Demographics
NPI:1326102476
Name:WORKMAN, JOHN A (DC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 DUVAL ST NW
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-1723
Mailing Address - Country:US
Mailing Address - Phone:386-688-3861
Mailing Address - Fax:
Practice Address - Street 1:216 DUVAL ST NW
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-1723
Practice Address - Country:US
Practice Address - Phone:386-688-3861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
103076OtherHIPPA COMOP
55826OtherBCBS
55826Medicare ID - Type Unspecified
CH0007654Medicare ID - Type Unspecified
U821390001Medicare UPIN