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Organization
TIMOTHY J MATTISON, MD INC
Active
Organization
TIMOTHY J MATTISON, MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J MATTISON M.D. (OWNER)
(419) 887-5833
Entity
Organization
Contact information
Practice address
5757 MONCLOVA RD STE 15, MAUMEE, OH 43537-1863
(419) 887-5833
(419) 887-5835
Mailing address
PO BOX 638132, CINCINNATI, OH 45263-0001
(419) 887-5833
(419) 887-5835
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB9527
RAILROAD MEDICARE
OH
Enumeration date
07/25/2006
Last updated
04/13/2009
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