Individual
JAMES WALLACE MATHEWSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 N RIM DR, SUITE A, FLAGSTAFF, AZ 86001-3134
(928) 779-7014
Mailing address
6404 E SETTLERS RUN RD, FLAGSTAFF, AZ 86004-7216
(858) 395-8652
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G29338
CA
2080P0202X
Pediatric Cardiology Physician
Primary
G29338
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G293380
—
CA
Enumeration date
11/13/2006
Last updated
09/11/2025
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