Individual
MR. DEAN L MATTOX II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3250 INTERTECH DR STE A, ANGOLA, IN 46703-7224
(260) 665-2646
(260) 665-8707
Mailing address
3250 INTERTECH DR STE A, ANGOLA, IN 46703-7224
(260) 665-2646
(260) 665-8707
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1052822A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200187510A
—
IN
Enumeration date
07/06/2006
Last updated
01/07/2010
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