Healthcare Provider Details

I. General information

NPI: 1245799394
Provider Name (Legal Business Name): JEFFREY PIPER MATTHEWS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 10/22/2023
Certification Date: 10/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 BALTIMORE PIKE STE B2
SPRINGFIELD PA
19064-3997
US

IV. Provider business mailing address

965 BALTIMORE PIKE STE B2
SPRINGFIELD PA
19064-3997
US

V. Phone/Fax

Practice location:
  • Phone: 484-573-5116
  • Fax: 484-573-5122
Mailing address:
  • Phone: 484-573-5116
  • Fax: 484-573-5122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS020943
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: