Individual
MATTHEW TY REDDICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 781-2727
Mailing address
1400 E DOWNING ST, TAHLEQUAH, OK 74464-3324
(918) 456-0641
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2024016785
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2021
Last updated
07/22/2024
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