Basic Information
Provider Information
NPI: 1023528726
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WORTH
FirstName: ANNA
MiddleName: CHRISTINE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5258 KATE CV
Address2:  
City: TRUSSVILLE
State: AL
PostalCode: 351731155
CountryCode: US
TelephoneNumber: 2565720323
FaxNumber:  
Practice Location
Address1: 2152 OLD SPRINGVILLE RD
Address2:  
City: CENTER POINT
State: AL
PostalCode: 352154005
CountryCode: US
TelephoneNumber: 2058386000
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/07/2017
LastUpdateDate: 07/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XL.4575RALN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000XMD.39138ALY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


Home