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General NPI Number Information
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NPI Number | 1619980919
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Entity Type | Individual
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Provider Name | GEORGE W MATHEWS DO
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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 | 02/22/2010
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Provider Practice Location Address
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Address Line | 201 S ARTHUR ST
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City | HUMANSVILLE
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State | MO
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Zip | 65674-8400
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Country | US
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Telephone | 417-754-2223
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Fax | 417-754-8046
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Provider Business Mailing Address
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Address Line | 1500 N OAKLAND AVE
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City | BOLIVAR
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State | MO
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Zip | 65613-3011
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Country | US
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Telephone | 417-754-2223
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Fax | 417-754-8046
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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 | DOR7A99
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License Number State | MO
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