Mattern, Allan Lee

Mattern, Allan Lee is an sole proprietor health care provider with primary practice located at 111 S 5Th St , Douglas WY 82633-2434. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Mattern, Allan Lee can be contacted via phone (307) 358-7300.

Contact Information

Primary practice address
111 S 5Th St Douglas WY 82633-2434
Phone: (307) 358-7300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 3059A Wyoming
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 3059A Wyoming

Profile Details

NPI number 1023175635
LBN Legal business name Mattern, Allan Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Dec 22nd, 2016 - about 9 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 1023175635 NPPES
Wyoming Other 304480 BLUE SHIELD
Wyoming Other 060025397 BLUE SHIELD
Wyoming Other 060040677 BLUE SHIELD
Wyoming MEDICAID 102651800 BLUE SHIELD

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