Provider Demographics
NPI:1679866412
Name:WORSHAM, LORA PALMER (MD)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:PALMER
Last Name:WORSHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1726
Mailing Address - Country:US
Mailing Address - Phone:931-783-5582
Mailing Address - Fax:931-526-6760
Practice Address - Street 1:128 N WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2493
Practice Address - Country:US
Practice Address - Phone:931-783-4600
Practice Address - Fax:931-783-4699
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN49321207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6020480OtherBCBS
TNQ007504Medicaid
KY7100420790Medicaid
KY7100420790Medicaid