Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 006.0092403 | VT |
Y | 111NN0400X | Neurology | CR1921 | ME |
NPI | 1851383285 |
---|---|
Provider Name | Dr. Richard Matthews |
First Address | Heber Springs, AR 72543-1014 |
Second Address | Ellsworth, ME 04605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 06/08/2018 |