Provider Demographics
NPI:1851383285
Name:MATTHEWS, RICHARD (DC DACNB)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:MATTHEWS
Suffix:
Gender:
Credentials:DC DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VIRGINIA AVE
Mailing Address - Street 2:#45
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34982-5893
Mailing Address - Country:US
Mailing Address - Phone:772-466-9575
Mailing Address - Fax:772-466-9475
Practice Address - Street 1:800 VIRGINIA AVE
Practice Address - Street 2:#45
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34982-5893
Practice Address - Country:US
Practice Address - Phone:772-466-9575
Practice Address - Fax:772-466-9475
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13817111NN0400X
MECR1921111NN0400X, 111NN0400X
NC3196111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR135498718Medicaid
AR59779Medicare ID - Type UnspecifiedARKANSAS BC/BS/MEDICARE