Individual
COLLEEN JAMES MATTOCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3707 BRAMBLETON AVE, ROANOKE, VA 24018-3658
(540) 725-7800
(540) 725-7849
Mailing address
3707 BRAMBLETON AVE, ROANOKE, VA 24018-3658
(540) 725-7800
(540) 725-7849
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102202851
VA
207Q00000X
Family Medicine Physician
37742
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VV2490A
MEDICARE PTAN
VA
Enumeration date
05/29/2008
Last updated
12/07/2020
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