Basic Information
| Provider Information | |||||||||
| NPI: | 1326194887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MATAS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | RONALD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.P.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2024 LINDBERG RD | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460122716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656432987 | ||||||||
| FaxNumber: | 7656400079 | ||||||||
| Practice Location | |||||||||
| Address1: | 2024 LINDBERG RD | ||||||||
| Address2: | |||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460122716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656432987 | ||||||||
| FaxNumber: | 7656400079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 07000845 | IN | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.