MEDICARE: DR. PATRICIA LYN MATTO 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
1	207Q00000X	Family Medicine Physician	34007023M	OH
2	207Q00000X	Family Medicine Physician	0102203314	VA
3	207Q00000X	Family Medicine Physician	DO.2755	AL

Other Identifiers

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

General Provider Information

NPI Number	:	1194715441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA LYN MATTO D.O.

Provider Business Mailing Address
First Line	:	1702 CATHERINE CT
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-5755
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 CATHERINE CT STE 1A
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-5790
Country	:	US
Telephone Number	:	334-501-1081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	06/10/2024

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