Mattax, James B

Mattax, James B is an individual health care provider with primary practice located at 1265 E Primrose St , Springfield MO 65804-4278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mattax, James B can be contacted via phone (417) 886-3937.

Contact Information

Primary practice address
1265 E Primrose St Springfield MO 65804-4278
Fax: (417) 886-1285
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X R9H41 Missouri

Profile Details

NPI number 1346244779
LBN Legal business name Mattax, James B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jul 1st, 2020 - about 4 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 1346244779 NPPES
Missouri MEDICAID 202545034
Missouri MEDICAID 202545026
Missouri Other 0840001
Missouri Other 32245
Missouri Other 118132
Missouri Other 822629
Missouri Other 1402

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