Organization
DR. JAMES C. MATTERN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES C. MATTERN DC, PC (PRESIDENT)
(765) 463-7337
Entity
Organization
Contact information
Practice address
1231 CUMBERLAND AVE D, WEST LAFAYETTE, IN 47906-1358
(765) 463-7337
(765) 497-4393
Mailing address
1231 CUMBERLAND AVE D, WEST LAFAYETTE, IN 47906-1358
(765) 463-7337
(765) 497-4393
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001204A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000092081
ANTHEM BCBS PROVIDER NUMB
IN
01
—
00630
ANTHEM MEDICAID
IN
Enumeration date
01/11/2007
Last updated
04/20/2008
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