Individual
DR. DAVID LEE MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2115
(417) 820-5344
Mailing address
PO BOX 504274, SAINT LOUIS, MO 63150-4274
(417) 820-6128
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125-051081
IL
207P00000X
Emergency Medicine Physician
Primary
2011032953
MO
207P00000X
Emergency Medicine Physician
D0103832
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356543706
—
MO
01
—
440552485
TRICARE
MO
Enumeration date
06/05/2007
Last updated
10/23/2025
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