Individual
DR. JAMES B MATTAX JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1265 E PRIMROSE ST, SPRINGFIELD, MO 65804-4278
(417) 886-3937
(417) 886-1285
Mailing address
1265 E PRIMROSE ST, SPRINGFIELD, MO 65804-4278
(417) 886-3937
(417) 886-1825
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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