Provider Demographics
NPI:1548342603
Name:WORTH, JAMES KEITH JR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEITH
Last Name:WORTH
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 E MAIN ST # 2
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-9218
Mailing Address - Country:US
Mailing Address - Phone:864-595-6117
Mailing Address - Fax:
Practice Address - Street 1:1531 E MAIN ST # 2
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-9218
Practice Address - Country:US
Practice Address - Phone:864-595-6117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555901111N00000X
SC3247111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA101758OtherANTHEM
VA190000852Medicare PIN
VAU70023Medicare UPIN