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1508804782

NPI Code Detail

MEDICARE: JEFFREY DAVID MATTHES MD

MEDICARE: JEFFREY DAVID MATTHES MD

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	2085R0202X	Diagnostic Radiology Physician	63689	TN
2	2085R0202X	Diagnostic Radiology Physician	17529	NE

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	300029831	OTHER	NE	RR MEDICARE

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508804782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DAVID MATTHES MD

Provider Business Mailing Address
First Line	:	PO BOX 7239
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80537-0239
Country	:	US
Telephone Number	:	402-489-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 DOWELL SPRINGS BLVD STE 200
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37909-2457
Country	:	US
Telephone Number	:	865-584-0291
Fax Number	:	865-584-4426

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	09/21/2023

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Directions to “ JEFFREY DAVID MATTHES MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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