Organization
M & T DERMATOLOGY SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK STEPHEN MATLOCK MD (OWNER)
(417) 624-0440
Entity
Organization
Contact information
Practice address
2829 S JACKSON AVE, JOPLIN, MO 64804-2525
(417) 624-0440
(417) 624-9652
Mailing address
2829 S JACKSON AVE, JOPLIN, MO 64804-2525
(417) 624-0440
(417) 624-9652
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
506068501
—
MO
01
—
DA0571
RAILROAD MEDICARE
—
Enumeration date
10/13/2005
Last updated
11/19/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us