Healthcare Provider Details

I. General information

NPI: 1588589162
Provider Name (Legal Business Name): JAMES T MATNEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7185 HARBOUR TOWNE PKWY S STE 200
SUFFOLK VA
23435-3896
US

IV. Provider business mailing address

7185 HARBOUR PARKWAY SOUTH SUITE 200
SUFFOLK VA
23435
US

V. Phone/Fax

Practice location:
  • Phone: 757-457-5100
  • Fax:
Mailing address:
  • Phone: 757-457-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: