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Organization
MATTISON PATHOLOGY, L.L.P.
Active
Organization
MATTISON PATHOLOGY, L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW WYNE (CFO)
(877) 232-9924
Entity
Organization
Contact information
Practice address
1800 RENAISSANCE BLVD STE L100, EDMOND, OK 73013-3023
(877) 232-9924
Mailing address
6221 RIVERSIDE DR STE 119, IRVING, TX 75039-3515
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
NULL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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