Individual
JOHN A MATTONI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19550 E 39TH ST S, SUITE 100, INDEPENDENCE, MO 64057-2303
(913) 428-2900
(913) 428-2951
Mailing address
8717 W 110TH ST, SUITE 600, OVERLAND PARK, KS 66210-2144
(913) 428-2900
(913) 428-2951
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
108692
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100180060B
—
MO
05
—
208886614
—
MO
Enumeration date
09/26/2006
Last updated
07/29/2013
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