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1588857874

NPI Code Detail

MEDICARE: MR. JOHN WILLIAM MATHEWSON MD

MEDICARE: MR. JOHN WILLIAM MATHEWSON 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	208600000X	Surgery Physician	MT185032	PA
2	208600000X	Surgery Physician	MT 185032	PA
3	2086S0105X	Surgery of the Hand (Surgery) Physician	N5229	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N5229	OTHER	TX	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588857874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN WILLIAM MATHEWSON MD

Provider Business Mailing Address
First Line	:	5615 DEAUVILLE STE 220
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79706-2707
Country	:	US
Telephone Number	:	432-221-5560
Fax Number	:

Provider Business Practice Location Address
First Line	:	5615 DEAUVILLE STE 220
Second Line	:
City	:	MIDLAND
State	:	TX
Zip	:	79706-2707
Country	:	US
Telephone Number	:	432-221-5560
Fax Number	:

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	09/08/2020

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Directions to “ MR. JOHN WILLIAM MATHEWSON MD” Practice Location

Language	Start Address	Practice Location

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