Individual
DOUGLAS E MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
947 EASTERN PKWY, LOUISVILLE, KY 40217-1573
(502) 361-8801
(502) 361-8821
Mailing address
3202 THOUSAND OAKS DR, LOUISVILLE, KY 40205-2703
(502) 361-8801
(502) 361-8821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34540
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64345408
—
KY
Enumeration date
04/20/2006
Last updated
11/27/2023
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