Individual
RICHARD MATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 BOB O LINK DR, STE 120, LEXINGTON, KY 40504-3759
(859) 277-3737
Mailing address
870 CORPORATE DR, STE. 400, LEXINGTON, KY 40503-5416
(859) 277-9436
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
4301039400
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1577948
—
MI
01
—
300F362430
BCBSM
MI
05
—
64129463
—
KY
01
—
P00396831
RR MEDICARE
KY
Enumeration date
03/28/2006
Last updated
01/29/2013
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