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NPI Code Detail

MEDICARE: MR. MATTHEW B HERNDON PA C

MEDICARE: MR. MATTHEW B HERNDON PA C
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
1363A00000XPhysician AssistantPA396AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10900180OTHERALUNITED HEALTHCARE
251000085OTHERALBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
47346659OTHERALAETNA

General Provider Information

NPI Number : 1235198417
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW B HERNDON PA C
Provider Business Mailing Address
First Line : 927 FRANKLIN ST SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-4306
Country : US
Telephone Number : 256-539-2728
Fax Number : 256-428-3423
Provider Business Practice Location Address
First Line : 927 FRANKLIN ST SE
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35801-4306
Country : US
Telephone Number : 256-539-2728
Fax Number : 256-428-3423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 02/02/2010

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