Provider Demographics
NPI:1104234210
Name:MATTHEWS, JOSHUA
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 BRIARVILLE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-5158
Mailing Address - Country:US
Mailing Address - Phone:615-460-4279
Mailing Address - Fax:615-460-4308
Practice Address - Street 1:1309 BRIARVILLE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5158
Practice Address - Country:US
Practice Address - Phone:615-460-4279
Practice Address - Fax:615-460-4308
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator