Provider Demographics
NPI:1326492356
Name:MATTHEWS, COY RYAN (MD)
Entity Type:Individual
Prefix:
First Name:COY
Middle Name:RYAN
Last Name:MATTHEWS
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 1:700 MEDICAL CENTER DRIVE
Mailing Address - Street 2:STE 150
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-9015
Mailing Address - Country:US
Mailing Address - Phone:316-283-7100
Mailing Address - Fax:316-283-7118
Practice Address - Street 1:700 MEDICAL CENTER DRIVE
Practice Address - Street 2:STE 150
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-9015
Practice Address - Country:US
Practice Address - Phone:316-283-7100
Practice Address - Fax:316-283-7118
Is Sole Proprietor?:No
Enumeration Date:2016-04-15
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-43105208D00000X
CAA151507208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice