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General NPI Number Information
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NPI Number | 1033600044
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Entity Type | Individual
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Provider Name | MATTHEW AARON PREVOST MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2018
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 87 19TH ST W STE 300
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City | JASPER
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State | AL
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Zip | 35501-5430
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Country | US
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Telephone | 205-221-3606
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Fax | 659-675-2225
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Provider Business Mailing Address
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Address Line | 87 19TH ST W STE 300
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City | JASPER
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State | AL
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Zip | 35501-5430
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Country | US
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Telephone | 205-221-3606
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Fax | 659-675-2225
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 009141
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | MD.48713
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD.48713
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License Number State | AL
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