MEDICARE: DR. MATTHEW DOOPER OD

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	152W00000X	Optometrist	OPT-OPT-LIC-3577	MT

General Provider Information

NPI Number	:	1801456686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW DOOPER OD

Provider Business Mailing Address
First Line	:	2012 14TH ST SW
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3412
Country	:	US
Telephone Number	:	406-453-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2012 14TH ST SW
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3412
Country	:	US
Telephone Number	:	406-453-1900
Fax Number	:

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

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	10/23/2024

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