Individual
DR. RICHARD W MATTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11130 KINGSTON PIKE STE 7&8, FARRAGUT, TN 37934-2865
(865) 675-1953
(865) 675-0877
Mailing address
1275 DICK LONAS RD, KNOXVILLE, TN 37909-1382
(865) 584-4747
(865) 584-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
60993
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278708300
—
FL
Enumeration date
09/06/2006
Last updated
06/22/2020
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