Provider Demographics
NPI:1669409843
Name:WORLEY II, EMERY EDWARD (MD)
Entity type:Individual
Prefix:
First Name:EMERY
Middle Name:EDWARD
Last Name:WORLEY II
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 HUDSON CIR
Mailing Address - Street 2:STE 2
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-3546
Mailing Address - Country:US
Mailing Address - Phone:318-387-3453
Mailing Address - Fax:318-323-9045
Practice Address - Street 1:1888 HUDSON CIR
Practice Address - Street 2:STE 2
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3546
Practice Address - Country:US
Practice Address - Phone:318-387-3453
Practice Address - Fax:318-323-9045
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0113612085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA300131921OtherRAILROAD MEDICARE
LA300131921OtherRR MEDICARE
LA1173029Medicaid
LA300131921OtherRAILROAD MEDICARE
LA5L857Medicare ID - Type Unspecified