Rodrigo B Mata Iii, M.D., S.C.

LBN: Rodrigo B Mata Iii, M.D., S.C.
Rodrigo B Mata Iii, M.D., S.C. is an health care organization with primary practice located at 6123 Green Bay Rd Ste 120 , Kenosha WI 53142-2927. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Rodrigo B Mata Iii, M.D., S.C. can be contacted via phone (262) 652-2710, or through Mata, Rodrigo B via phone (262) 652-2710.

Contact Information

Primary practice address
6123 Green Bay Rd Ste 120 Kenosha WI 53142-2927
Phone: (262) 652-2710
Fax: (262) 652-1370
Website:
Map and Directions
Authorized official contact:
Name: Mata, Rodrigo B Doctor of Medicine (MD)
Phone: (262) 652-2710

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 33893 Wisconsin

Profile Details

NPI number 1588847099
LBN Legal business name Rodrigo B Mata Iii, M.D., S.C.
DBA Doing business as
Authorized official Mata, Rodrigo B Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 7th, 2007
Last updated Jun 3rd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588847099 NPPES
Wisconsin MEDICAID 21286100

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