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NPI Code Detail

MEDICARE: STEVEN JOHN MATTAS MD

MEDICARE: STEVEN JOHN MATTAS 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
1207W00000XOphthalmology Physician24542KY

Other Identifiers

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

General Provider Information

NPI Number : 1578547550
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN JOHN MATTAS MD
Provider Business Mailing Address
First Line : 1935 BLUEGRASS AVE
Second Line : SUITE 200
City : LOUISVILLE
State : KY
Zip : 40215-1179
Country : US
Telephone Number : 502-895-0040
Fax Number : 502-361-4488
Provider Business Practice Location Address
First Line : 1935 BLUEGRASS AVE
Second Line : SUITE 200
City : LOUISVILLE
State : KY
Zip : 40215-1179
Country : US
Telephone Number : 502-895-0040
Fax Number : 502-361-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2005
Last Update Date : 09/23/2013

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