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NPI Code Detail

MEDICARE: DR. MATTHEW JOSEPH PREVOST MD

MEDICARE: DR. MATTHEW JOSEPH PREVOST 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
1207Q00000XFamily Medicine PhysicianR81747AZ

General Provider Information

NPI Number : 1962290304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW JOSEPH PREVOST MD
Provider Business Mailing Address
First Line : 1847 S MATH QUIZ DR
Second Line :
City : TUCSON
State : AZ
Zip : 85711-0007
Country : US
Telephone Number : 906-362-1812
Fax Number :
Provider Business Practice Location Address
First Line : 655 N ALVERNON WAY STE 228
Second Line :
City : TUCSON
State : AZ
Zip : 85711-1853
Country : US
Telephone Number : 520-626-2551
Fax Number : 520-694-1640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2025
Last Update Date : 07/23/2025

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Directions to “ DR. MATTHEW JOSEPH PREVOST MD” Practice Location

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