Smith, Matthew R

Smith, Matthew R is an individual health care provider with primary practice located at 1414 Cross Street Suite 330, Shiloh IL 62269-2998. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Smith, Matthew R can be contacted via phone (618) 277-7400.

Contact Information

Primary practice address
1414 Cross Street Suite 330 Shiloh IL 62269-2998
Phone: (618) 277-7400
Fax: (618) 277-7422
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X OS020766 Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X 036157198 Illinois

Profile Details

NPI number 1538540679
LBN Legal business name Smith, Matthew R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2015
Last updated Mar 20th, 2024 - about last year

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 1538540679 NPPES
Other 14956575 CAQH
MEDICAID 103811031 CAQH

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