Healthcare Provider Details

I. General information

NPI: 1194809103
Provider Name (Legal Business Name): ARTHUR LEE MATTHEWS III DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 ROSWELL RD NE STE 140
ATLANTA GA
30305-1836
US

IV. Provider business mailing address

3046 MOSER WAY STE 32
MARIETTA GA
30060-6340
US

V. Phone/Fax

Practice location:
  • Phone: 678-571-2595
  • Fax:
Mailing address:
  • Phone: 678-571-2595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCHIR008202
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCHIR008202
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCHIR008202
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHIR008202
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberCHIR008202
License Number StateGA
# 6
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008202
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: