Provider Demographics
NPI:1457720708
Name:WORRELL, RUBY REXENE (MD)
Entity type:Individual
Prefix:DR
First Name:RUBY
Middle Name:REXENE
Last Name:WORRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1225 LOS MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1903
Mailing Address - Country:US
Mailing Address - Phone:702-682-7777
Mailing Address - Fax:702-543-4013
Practice Address - Street 1:1225 LOS MEADOWS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-1903
Practice Address - Country:US
Practice Address - Phone:702-682-7777
Practice Address - Fax:702-543-4013
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-16
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV9890207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology