Provider Demographics
NPI:1710748652
Name:STARLING, MATTHEW D
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:D
Last Name:STARLING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 HIGHWAY 105
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-8368
Mailing Address - Country:US
Mailing Address - Phone:334-689-3510
Mailing Address - Fax:
Practice Address - Street 1:2826 ROSS CLARK CIR STE 103
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-2017
Practice Address - Country:US
Practice Address - Phone:334-689-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF1240165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily