Healthcare Provider Details

I. General information

NPI: 1972131548
Provider Name (Legal Business Name): CHRISTINE A MATTHEWS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 MADISON AVE
MEMPHIS TN
38103-3409
US

IV. Provider business mailing address

PO BOX 749112
ATLANTA GA
30374-9112
US

V. Phone/Fax

Practice location:
  • Phone: 901-515-5943
  • Fax: 901-515-4749
Mailing address:
  • Phone: 434-295-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101283872
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number247486
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: