Individual
MATTHEW GLEN CHECKETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2850 E MAIN ST STE 106, MESA, AZ 85213-9304
(480) 618-0019
Mailing address
PO BOX 746093, ATLANTA, GA 30374-6093
(773) 352-1517
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
007545
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518344753
—
IA
Enumeration date
04/27/2015
Last updated
01/11/2024
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