Provider Demographics
NPI:1881809713
Name:WORTHING, NATHANIEL JAMES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:JAMES
Last Name:WORTHING
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4373 DONNELY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-8872
Mailing Address - Country:US
Mailing Address - Phone:517-764-7353
Mailing Address - Fax:
Practice Address - Street 1:3075 W CLARK RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1103
Practice Address - Country:US
Practice Address - Phone:734-434-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030235183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist