# GARY A MATTHYS MD PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MATTHYS ORTHOPAEDIC CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073840492
- **Authorized official:** ABBY LEWIS (OFFICE MANAGER)
- **Authorized official phone:** (701) 241-9300

## Contact information

- **Practice address:** 213 STATE ST W, DETROIT LAKES, MN 56501-3005
- **Practice address phone:** (701) 241-9300
- **Practice address fax:** (701) 235-4525
- **Mailing address:** 2301 25TH ST S, SUITE I, FARGO, ND 58103-6104
- **Mailing address phone:** (701) 241-9300
- **Mailing address fax:** (701) 235-4525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 8590 | ND | Yes |

## Other

- **Enumeration date:** 11/05/2009
- **Last updated:** 11/05/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 14488 | — | ND |
| 01 | — | 6I410MA | BCBS MN | MN |
| 05 | — | 708457000 | — | MN |
| 05 | — | 7700312 | — | SD |
| 01 | — | 9809527 | MEDICA | MN |
| 01 | — | HP32046 | HEALTHPARTNERS | MN |