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NPI Code Detail

MEDICARE: PAUL P MATTHEWS D.O

MEDICARE: PAUL P MATTHEWS D.O
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician021197LA
22084P0800XPsychiatry Physician5683OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063406437
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL P MATTHEWS D.O
Provider Business Mailing Address
First Line : 6600 S YALE AVE STE 1400
Second Line :
City : TULSA
State : OK
Zip : 74136-3331
Country : US
Telephone Number : 918-499-4855
Fax Number : 918-488-6098
Provider Business Practice Location Address
First Line : 300 ROCKEFELLER DR
Second Line :
City : MUSKOGEE
State : OK
Zip : 74401-5075
Country : US
Telephone Number : 918-682-5501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 07/23/2025

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