Provider Demographics
NPI:1508845785
Name:MATTHEW, STEPHEN MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MARK
Last Name:MATTHEW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23601
Mailing Address - Street 2:
Mailing Address - City:BARLING
Mailing Address - State:AR
Mailing Address - Zip Code:72923-0601
Mailing Address - Country:US
Mailing Address - Phone:479-783-0369
Mailing Address - Fax:479-783-0419
Practice Address - Street 1:720A STROZIER LN
Practice Address - Street 2:
Practice Address - City:BARLING
Practice Address - State:AR
Practice Address - Zip Code:72923-1735
Practice Address - Country:US
Practice Address - Phone:479-783-0369
Practice Address - Fax:479-783-0419
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1276171100000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5C831OtherMEDICARE PTAN