Gregg R Mattison M.D.

NPI 1023062130 - Radiology - 2085R0202X

NPI Details
NPI 1023062130
Gender Male
Enumeration Date 05/22/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
3707 NEW VISION DRIVE
FORT WAYNE IN, 46895-5602, US
Phone (260) 471-9466
Fax (260) 484-5919
Business Location
2200 RANDALLIA DR
FORT WAYNE IN, 46805-4638, US
Phone (260) 373-4731
Fax
Toxanomy
Taxonomy Code 2085R0202X
License State Indiana
License Number 35188
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According to our database, Dr. Gregg R Mattison M.D. NPI is 1023062130, taxonomy code is 2085R0202X and license number is 35188, license state is located at Indiana. Gregg R Mattison M.D. physically located at 3707 New Vision Drive, Fort Wayne IN, 46895-5602. NPI Number Gregg R Mattison M.D. has the Individual type.

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1023062130 NPI number is provided on an as is basis without warranty of any kind. 1023062130 is maintained by the National Plan & Provider Enumeration System. The contents of Gregg R Mattison M.D. are for informational purposes only.