Healthcare Provider Details

I. General information

NPI: 1972605897
Provider Name (Legal Business Name): MATTHEW HARDIN NETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 01/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 SPRING ST SUITE 2
JEFFERSONVILLE IN
47130-3704
US

IV. Provider business mailing address

1214 SPRING ST SUITE 2
JEFFERSONVILLE IN
47130-3704
US

V. Phone/Fax

Practice location:
  • Phone: 812-283-5950
  • Fax: 812-285-5439
Mailing address:
  • Phone: 812-283-5950
  • Fax: 812-285-5439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number55517
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.099453
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number01071272A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number45329
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: