MEDICARE: DR. STEPHEN MARK MATTHEW DC

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	171100000X	Acupuncturist	1276	AR
2	111N00000X	Chiropractor	1276	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5C831	OTHER	AR	MEDICARE PTAN

General Provider Information

NPI Number	:	1508845785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN MARK MATTHEW DC

Provider Business Mailing Address
First Line	:	PO BOX 23601
Second Line	:
City	:	BARLING
State	:	AR
Zip	:	72923-0601
Country	:	US
Telephone Number	:	479-783-0369
Fax Number	:	479-783-0419

Provider Business Practice Location Address
First Line	:	720A STROZIER LN
Second Line	:
City	:	BARLING
State	:	AR
Zip	:	72923-1735
Country	:	US
Telephone Number	:	479-783-0369
Fax Number	:	479-783-0419

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	03/07/2024

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Directions to “ DR. STEPHEN MARK MATTHEW DC” Practice Location

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