Provider Demographics
NPI:1104873587
Name:WORKMAN, MICHAEL J (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:WORKMAN
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:PO BOX 9434
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65801-9434
Mailing Address - Country:US
Mailing Address - Phone:417-885-3888
Mailing Address - Fax:417-881-7638
Practice Address - Street 1:2900 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-3634
Practice Address - Country:US
Practice Address - Phone:417-885-3888
Practice Address - Fax:417-881-7638
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002031632207T00000X, 2085N0700X
ARE4419207T00000X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5N251OtherARKANSAS FIRST SOURCE
MO18271OtherCOX HEALTH PLANS UPI
MO4515931001OtherCIGNA HEALTHCARE
WA0214845OtherDEPARTMENT OF LABOR WA
MOH00794OtherUSPS (W/C)
MO05050016400OtherQUAL CHOICE
AR162037001Medicaid
AR5N251OtherHEALTH ADVANTAGE
MO177827OtherBLUE CROSS/CHOICE
MO4188130001OtherCIGNA MEDICARE
AR5N251OtherARKANSAS BC/BS
MO1602599OtherUNITED HEALTHCARE
MO203066607Medicaid
MO177827OtherBLUE CROSS/CHOICE
MOH00794Medicare UPIN
AR5AH64C687Medicare PIN
MO18271OtherCOX HEALTH PLANS UPI
MOP00140539Medicare PIN
MO05050016400OtherQUAL CHOICE
AR5N251OtherHEALTH ADVANTAGE
MO1602599OtherUNITED HEALTHCARE
MOMA3059001Medicare PIN