Jill Marie Wortham, PA-C is a
Physician Assistant physician based in Tyler, Texas. Jill Marie Wortham is licensed to practice in Texas (license number PA01852) and her current practice location is 6210 S. Broadway, Tyler, Texas. She can be reached at her office (for appointments etc.) via phone at
(800) 893-9698.
NPI number for Jill Marie Wortham is 1346279031 and her current mailing address is 5904 Churchill Dr, Suite 201, Tyler, Texas. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1346279031.
Physician's Profile
| Full Name | Jill Marie Wortham |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 6210 S. Broadway, Tyler, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346279031
- Provider Enumeration Date: 07/03/2006
- Last Update Date: 12/22/2015
Medical Identifiers
Medical identifiers for Jill Marie Wortham such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346279031 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | PA01852 (Texas) | Secondary |
| 363A00000X | Physician Assistant | PA01852 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jill Marie Wortham is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jill Marie Wortham, PA-C
5904 Churchill Dr, Suite 201,
Tyler, TX 75703-4556
Ph: (800) 893-9698 | Jill Marie Wortham, PA-C
6210 S. Broadway,
Tyler, TX 75703
Ph: (800) 893-9698 |
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