Individual
THOMAS PAUL MATTINGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01026310A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000086144
ANTHEM INSURANCE
IN
01
—
35-1654025
AETNA
IN
01
—
351654025
BANKERS LIFE
IN
01
—
351654025 47904 002
TRICARE
IN
01
—
B29527
ADVANTAGE HEALTH SOLUTION
IN
Enumeration date
01/07/2006
Last updated
06/11/2012
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