Provider Demographics
NPI:1437198363
Name:JOHN J WORTHINGTON MD
Entity Type:Organization
Organization Name:JOHN J WORTHINGTON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WORTHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-657-9880
Mailing Address - Street 1:569 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-3017
Mailing Address - Country:US
Mailing Address - Phone:215-542-3920
Mailing Address - Fax:215-784-1128
Practice Address - Street 1:1000 YORK RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1318
Practice Address - Country:US
Practice Address - Phone:215-657-9880
Practice Address - Fax:215-657-1128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009352E2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty