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General NPI Number Information
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NPI Number | 1437262623
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Entity Type | Individual
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Provider Name | BOBAN N MATHEW M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 1201 E CENTENNIAL DR
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City | PITTSBURG
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State | KS
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Zip | 66762-6623
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Country | US
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Telephone | 620-231-0204
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Fax | 620-308-7240
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Provider Business Mailing Address
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Address Line | PO BOX 3810
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City | JOPLIN
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State | MO
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Zip | 64803-3810
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Country | US
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Telephone | 417-347-4662
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0425243
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License Number State | KS
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