Mattison, Ronald Edwin

Mattison, Ronald Edwin is an individual health care provider with primary practice located at 6005 Park Ave Suite 700, Memphis TN 38119-5202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mattison, Ronald Edwin can be contacted via phone (901) 527-3391.

Contact Information

Primary practice address
6005 Park Ave Suite 700 Memphis TN 38119-5202
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 048275 Georgia
Allopathic & Osteopathic Physicians / Surgery 208600000X 036118870 Illinois
Allopathic & Osteopathic Physicians / Surgery 208600000X 45847 Tennessee

Profile Details

NPI number 1396723748
LBN Legal business name Mattison, Ronald Edwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Sep 15th, 2010 - about 14 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 1396723748 NPPES
Illinois Other 135084 HAMP
Illinois Other 3932056 HAMP
Illinois Other 869299 HAMP
Illinois MEDICAID 036118070 HAMP
Illinois Other 7210895 HAMP
Illinois Other 320875 HAMP

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