Justus, Matthew L

Justus, Matthew L is an individual health care provider with primary practice located at 202 Town Square St. , Glade Spring VA 24340. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Justus, Matthew L can be contacted via phone (276) 429-1410.

Contact Information

Primary practice address
202 Town Square St. Glade Spring VA 24340
Phone: (276) 429-1410
Fax: (276) 783-2879
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 0110001912 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 01170 West Virginia
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0110001912 Virginia

Profile Details

NPI number 1821033895
LBN Legal business name Justus, Matthew L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated May 20th, 2021 - 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 1821033895 NPPES
Tennessee MEDICAID Q007384
Tennessee Other P01198022
Tennessee MEDICAID 1821033895

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