Basic Information
| Provider Information | |||||||||
| NPI: | 1023329216 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAGGETT | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | C. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 SE BLUE PKWY | ||||||||
| Address2: | SUITE # 230 | ||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640631041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165252840 | ||||||||
| FaxNumber: | 8165252841 | ||||||||
| Practice Location | |||||||||
| Address1: | 2000 SE BLUE PKWY | ||||||||
| Address2: | SUITE # 230 | ||||||||
| City: | LEES SUMMIT | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640631041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165252840 | ||||||||
| FaxNumber: | 8165252841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2010 | ||||||||
| LastUpdateDate: | 08/01/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2010017408 | MO | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.