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Organization
JACK M. MATHENY II, M.D.
Active
Organization
JACK M. MATHENY II, M.D.
Active
Parent organization
JACK M MATHENY II MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
JACK M MATHENY II MD
Authorized official
DR. JACK MEADOWS MATHENY II M.D. (OWNER)
(386) 328-6746
Entity
Organization
Contact information
Practice address
700 ZEAGLER DR STE 10, PALATKA, FL 32177-3826
(328) 328-6746
Mailing address
205 ZEAGLER DR, STE 101, PALATKA, FL 32177-3888
(328) 328-6746
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372143400
—
FL
05
—
372143401
—
FL
Enumeration date
05/28/2006
Last updated
09/12/2024
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