Individual
INA J MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
641 MIDDLE CREEK RD, SEVIERVILLE, TN 37862-5014
(865) 428-0583
Mailing address
1225 E WEISGARBER RD, STE 200, KNOXVILLE, TN 37909-2604
(865) 584-4747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0430
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3706637
MEDICARE LEGACY GROUP
TN
Enumeration date
12/01/2006
Last updated
05/08/2008
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