Provider Demographics
NPI:1962935387
Name:OCZYPOK, MATTHEW PAUL (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PAUL
Last Name:OCZYPOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 N BROAD STREET EXT
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4603
Mailing Address - Country:US
Mailing Address - Phone:724-450-7000
Mailing Address - Fax:
Practice Address - Street 1:631 N BROAD ST EXT
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137
Practice Address - Country:US
Practice Address - Phone:724-450-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD469655207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty