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General NPI Number Information
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NPI Number | 1194715441
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Entity Type | Individual
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Provider Name | PATRICIA LYN MATTO D.O.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 1702 CATHERINE CT STE 1A
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City | AUBURN
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State | AL
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Zip | 36830-5790
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Country | US
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Telephone | 334-501-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 1702 CATHERINE CT
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City | AUBURN
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State | AL
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Zip | 36830-5755
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34007023M
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0102203314
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO.2755
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License Number State | AL
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