Provider Demographics
NPI:1447209796
Name:MATTHEWS, JEFFREY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARK
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9233 WARD PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3366
Mailing Address - Country:US
Mailing Address - Phone:816-389-6030
Mailing Address - Fax:816-389-6034
Practice Address - Street 1:4401 WORNALL RD
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3220
Practice Address - Country:US
Practice Address - Phone:816-389-6030
Practice Address - Fax:816-389-6034
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
MOR7G14207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO13215032OtherBCBS NUMBER
MO13215032OtherBCBS NUMBER
MOE04838Medicare UPIN