Individual
HEATHER BENNETT MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Mailing address
520 MARY ST STE 520, EVANSVILLE, IN 47710-1682
(812) 424-8231
(812) 435-8794
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
01081542A
IN
208C00000X
Colon & Rectal Surgery Physician
99090610A
IN
208C00000X
Colon & Rectal Surgery Physician
ME129307
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003181483A
—
GA
01
—
01081542A
IN PROFESSIONAL LICENSING AGENCY
IN
05
—
018439300
—
FL
05
—
300021719
—
IN
05
—
7100581930
—
KY
01
—
99090610A
IN TEMPORARY LICENSE
IN
01
—
IR482Z
MEDICARE
FL
Enumeration date
04/07/2010
Last updated
03/04/2024
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