Mattox, Joseph M

Mattox, Joseph M is an individual health care provider with primary practice located at 5050 N Clinton St , Fort Wayne IN 46825-5886. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Mattox, Joseph M can be contacted via phone (260) 484-8551.

Contact Information

Primary practice address
5050 N Clinton St Fort Wayne IN 46825-5886
Phone: (260) 484-8551
Fax: (260) 482-5060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 01051027A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 2080S0010X 01051027A Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01051027A Indiana

Profile Details

NPI number 1154367944
LBN Legal business name Mattox, Joseph M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2006
Last updated Oct 7th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154367944 NPPES
Indiana Other P00846132 MEDICARE RR
Indiana Other 11180921 MEDICARE RR
Indiana MEDICAID 200187520 MEDICARE RR

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