Individual
DR. KELLY DAWN MATTIX
Active
Individual
DR. KELLY DAWN MATTIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E-17038
AR
2086S0120X
Pediatric Surgery Physician
Primary
E-17038
AR
2086S0120X
Pediatric Surgery Physician
N7560
TX
Other
Enumeration date
04/11/2008
Last updated
10/03/2023
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