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General NPI Number Information
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NPI Number | 1891884029
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Entity Type | Individual
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Provider Name | MATTHEW K WEBSTER DO
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Gender | Male
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 1105 N ANKENY BLVD STE 100
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City | ANKENY
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State | IA
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Zip | 50023-4003
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Country | US
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Telephone | 515-964-4600
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Fax | 515-963-4142
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Provider Business Mailing Address
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Address Line | 1105 N ANKENY BLVD STE 100
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City | ANKENY
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State | IA
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Zip | 50023-4003
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Country | US
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Telephone | 515-964-4600
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Fax | 515-963-4142
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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 | R7929
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License Number State | IA
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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 | DO-03820
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | DO-03820
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License Number State | IA
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