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Individual

DR. JAMES B MATTAX JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R9H41
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0840001
UNITED HC OF MIDWEST
MO
01
118132
BLUE CROSS/SHIELD ST.LOU
MO
01
1402
COX HEALTH INS
MO
05
202545026
MO
05
202545034
MO
01
32245
OPTICARE
MO
01
822629
HEALTHCARE PREFERRED
MO
Enumeration date
06/13/2005
Last updated
07/01/2020
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