Healthcare Provider Details

I. General information

NPI: 1225036569
Provider Name (Legal Business Name): DANIEL E. MATTHEWS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 JORDAN RD SUITE A
DAPHNE AL
36526-4728
US

IV. Provider business mailing address

6401 JORDAN RD STE A
DAPHNE AL
36526-4771
US

V. Phone/Fax

Practice location:
  • Phone: 251-491-2676
  • Fax: 251-491-2685
Mailing address:
  • Phone: 251-491-2676
  • Fax: 251-491-2685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number21607
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number21607
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: