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Individual

DR. BILL JEFFREY MATHIAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4800 NE STALLINGS, STE 1100, NACOGDOCHES, TX 75965
(936) 560-4100
(936) 560-6093
Mailing address
3624 BUCKINGHAM DRIVE, NACOGDOCHES, TX 75965
(936) 569-6041
(936) 560-6093

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
J8312
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0017KW
BLUE CROSS BLUE SHIELD
TX
05
116234904
TX
Enumeration date
07/07/2006
Last updated
08/19/2011
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