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Individual

KEVIN M MATTESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1311A N MILDRED RD, STE A, CORTEZ, CO 81321-2231
(970) 564-2681
(970) 564-2682
Mailing address
1311A N MILDRED RD, CORTEZ, CO 81321-2231

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DR.0039709
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40984567
CO
Enumeration date
06/29/2005
Last updated
11/27/2023
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