Provider Demographics
NPI:1699740662
Name:MATSON, PAUL CURTIS (MD)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CURTIS
Last Name:MATSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 PREMIER DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6076
Mailing Address - Country:US
Mailing Address - Phone:507-386-6600
Mailing Address - Fax:507-625-5971
Practice Address - Street 1:1431 PREMIER DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6076
Practice Address - Country:US
Practice Address - Phone:507-386-6600
Practice Address - Fax:507-625-5971
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN27349207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN14626MAOtherBCBS OF MN
MNHP18780OtherHEALTH PARTNERS
MN0900628OtherMEDICA, SPRINGFIELD
MN0907585OtherMEDICA, REDWOOD FALLS
MN115242C572OtherUCARE MN
MN0901558OtherMEDICA, MANKATO
MN983181004375OtherPREFERRED ONE
MN223770900Medicaid
MN410940705H013OtherTRICARE/WPS
MN0900628OtherMEDICA, SPRINGFIELD
MN14626MAOtherBCBS OF MN
MN200022660Medicare ID - Type UnspecifiedPALMETTO GBA, RR MC