Healthcare Provider Details
I. General information
NPI: 1255095261
Provider Name (Legal Business Name): MAT MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/26/2021
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3871 OLD US HWY 278 EAST
HOKES BLUFF AL
35903
US
IV. Provider business mailing address
3871 OLD US HWY 278 EAST
HOKES BLUFF AL
35903
US
V. Phone/Fax
- Phone: 256-492-0544
- Fax: 256-492-0558
- Phone: 256-492-0544
- Fax: 256-492-0558
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENDY
SPRAYBERRY
Title or Position: DIRECTOR
Credential:
Phone: 256-997-6502