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NPI Code Detail

MEDICARE: DR. MATTHEW WILLIAM SOUTHWICK M.D.

MEDICARE: DR. MATTHEW WILLIAM SOUTHWICK M.D.
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
1208000000XPediatrics Physician35-07-3961-SOH
2208000000XPediatrics PhysicianME137061FL

Other Identifiers

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

General Provider Information

NPI Number : 1669451282
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW WILLIAM SOUTHWICK M.D.
Provider Business Mailing Address
First Line : 2315 W JACKSON ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32505-7552
Country : US
Telephone Number : 850-760-0669
Fax Number : 850-898-9428
Provider Business Practice Location Address
First Line : 2315 W JACKSON ST
Second Line :
City : PENSACOLA
State : FL
Zip : 32505-7552
Country : US
Telephone Number : 850-760-0669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2006
Last Update Date : 04/16/2025

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