Individual
MRS. JESSICA T MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1003 WILLOW CREEK RD, PRESCOTT, AZ 86301-1641
(928) 771-5786
(928) 771-5787
Mailing address
1565 MAJESTIC WAY, PRESCOTT, AZ 86301-5452
(928) 925-6574
(928) 771-5787
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
045521
WI
207P00000X
Emergency Medicine Physician
Primary
37844
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34446800
—
WI
Enumeration date
09/20/2006
Last updated
06/11/2014
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