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General NPI Number Information
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NPI Number | 1215947049
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Entity Type | Individual
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Provider Name | MATHUKUTTY JOSEPH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 393 OAK STREET SUITE 100
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City | SPINDALE
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State | NC
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Zip | 28160-1531
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Country | US
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Telephone | 828-287-3928
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Fax | 828-286-3137
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Provider Business Mailing Address
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Address Line | 393 OAK STREET SUITE 100
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City | SPINDALE
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State | NC
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Zip | 28160-1531
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Country | US
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Telephone | 828-287-3928
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Fax | 828-286-3137
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2005-00596
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 227931-1
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License Number State | NY
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