Craig K. Matheson, D.o., P.l.l.c., NPI 1205961745
Primary Care Clinic/Center in Scottville, MI, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1205961745
NPI Entity Type Organization
Provider Name Craig K. Matheson, D.o., P.l.l.c.
Doing Business As
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 821 W Us Highway 10 31, Scottville, MI, US
Provider Mailing Address 821 West U.s. Highway 10, Scottville, MI, US, 49454
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name DR. D.O. Craig Kenneth Matheson
Official Position OWNER AND SOLE MEMBER
Phone 231-757-2500

Primary Taxonomy

Taxonomy Code

261QP2300X

Taxonomy Name Primary Care Clinic/Center
Classification

Clinic/Center

Group

Ambulatory Health Care Facilities

License No. 5101011416
License State MI
Description Definition to come...

Other Organization Name

Third Coast Family Practice
Doing Business As

Business Address

Craig K. Matheson, D.o., P.l.l.c.
821 W Us Highway 10 31

Scottville, MI, US

Phone: 231-757-2500
Fax: 231-757-9073

Mailing Address

Craig K. Matheson, D.o., P.l.l.c.
821 West U.s. Highway 10
Scottville, MI, US
ZIP 49454
Phone: 231-757-2500
Fax: 231-757-9073

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
CLIA MI 23D1038209 01
4615194 MI MEDICAID 05
0855301234 MI BLUE CROSS BLUE SHIELD ID 01

Health Information Exchange

Endpoint Type Endpoint Description Use Content Type Affiliation Location
FHIR https://fhir.healow.com/FHIRServer/fhir/GICAAA/metadata No 821 W US Highway 10 31, Scottville, MI, US

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Logan Morse

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Pharmacist

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Ada, MI

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