Individual
DR. JON ROBERT MATTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5830 NW BARRY RD, KANSAS CITY, MO 64154-2778
(816) 880-6200
(816) 880-6206
Mailing address
5830 NW BARRY RD, KANSAS CITY, MO 64154-2778
(816) 880-6200
(816) 880-6206
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
2000165578
MO
207Q00000X
Family Medicine Physician
Primary
2000165578
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
502240708
—
MO
01
—
T92000001
MEDICARE PTAN CLINIC
MO
01
—
W05000001
MEDICARE PTAN-HOSPITAL
MO
Enumeration date
08/15/2006
Last updated
03/14/2023
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